Individual provider Active NPI

Valerie O Pullen, LCSW

  • Mental Health Counselor
  • Fort Pierce, FL
National Provider Identifier
1366783979
Registry record updated Jan 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Practice address
2812 Serenity Cir S
Fort Pierce, FL 34981-5053
Phone
(772) 259-6668
NPI assigned
Mar 6, 2013
Last updated
Jan 10, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 10, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X NU Primary
Clinical Social Worker 1041C0700X NU
Case Manager/Care Coordinator 171M00000X NU

Addresses

Primary practice location

2812 Serenity Cir S
Fort Pierce, FL 34981-5053

Mailing address

2812 Serenity Cir S
Fort Pierce, FL 34981-5053
Phone (772) 259-6668

Other practice location 1

518 NW Prima Vista Blvd
Port Saint Lucie, FL 34983-3498
Phone (772) 873-8811

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20211124000202 FL Practitioner - Clinical Social Worker 1759771280 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Legacy Behavioral Health Center Inc CurrentSince Nov 29, 2021 Accepting new patients
Grow Healthcare Group PA Mental Health CurrentSince Jan 9, 2024 Accepting new patients
Inner Reins Counseling, LLC Mental Health CurrentSince Sep 28, 2021 Accepting new patients
Legacy Behavioral Health Center Inc Clinical CurrentSince Nov 29, 2021 Accepting new patients

Locations

15818 SW Warfield Blvd
Indiantown, FL 34956
Phone (772) 597-0411

66 W Flagler St
Ste 900
Miami, FL 33130
Phone (786) 244-7711

518 SW Prima Vista Blvd
Port St Lucie, FL 34983
Phone (772) 344-2293

2640 Forest Hill Blvd
West Palm Beach, FL 33406
Phone (561) 275-7100

Networks

  • Freedom Health HMO Network

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1362528000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704844800000",
    "number": "1366783979",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2812 SERENITY CIR S",
            "city": "FORT PIERCE",
            "state": "FL",
            "postal_code": "349815053",
            "telephone_number": "772-259-6668"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2812 SERENITY CIR S",
            "city": "FORT PIERCE",
            "state": "FL",
            "postal_code": "349815053",
            "telephone_number": "772-259-6668"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "518 NW Prima Vista Blvd",
            "address_purpose": "LOCATION",
            "city": "Port Saint Lucie",
            "state": "FL",
            "postal_code": "349833498",
            "country_code": "US",
            "telephone_number": "772-873-8811",
            "fax_number": "772-873-8800",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PULLEN",
        "first_name": "VALERIE",
        "middle_name": "O",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-03-06",
        "last_updated": "2024-01-10",
        "certification_date": "2024-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Pierce, FL

Sources for this page

Verify at the official NPI Registry.