Ilene Marie Vallance, LMSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

6801078151 Issued in MI

Practice address

3333 Moores River Dr Unit 208
Lansing, MI 48911-1054

Phone

(517) 614-3903

NPI assigned

Apr 20, 2006

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other names 1

• Ilene Marie Jolly Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Interoperability endpoints

• Direct secure messaging: lifestancehealth.ilenejolly@150339.advancedmd-direct.com

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1145491200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1685404800000",
    "number": "1275598138",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3333 MOORES RIVER DR UNIT 208",
            "city": "LANSING",
            "state": "MI",
            "postal_code": "489111054",
            "telephone_number": "517-614-3903"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3333 MOORES RIVER DR UNIT 208",
            "city": "LANSING",
            "state": "MI",
            "postal_code": "489111054",
            "telephone_number": "517-614-3903"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VALLANCE",
        "first_name": "ILENE",
        "middle_name": "MARIE",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-20",
        "last_updated": "2023-05-30",
        "certification_date": "2023-05-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801078151",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ILENE",
            "last_name": "JOLLY",
            "middle_name": "MARIE",
            "credential": "LMSW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Jessica Vainner
• Leslie Vainner
• Robert Adam Vaitkevicius, RBT
• Samantha Vaive, MSW, PHD
• Mallory Kathryn Valdez, NP
• Luis G Valle, M.D.
• Ricardo Valles
• Janet Van Beelen
• Alyssa Nadine Van Fossen, LLMSW
• Deborah Van Hal, LLMSW

• Clinical Social Worker in Lansing, MI
• Providers in Lansing, MI by specialty
• Clinical Social Worker in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 30, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.