Active NPI
Ada M Valladares, MSW
- Mental Health Counselor
- Los Angeles, CA
National Provider Identifier
1407193667
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 33817
- Practice address
- 2100 W 3Rd St
Los Angeles, CA 90057-1944 - Phone
- (323) 269-7066
- NPI assigned
- Jan 8, 2013
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 79279 | CA | |
| Mental Health Counselor | 101YM0800X | 33817 | CA | Primary |
Addresses
Primary practice location
2100 W 3Rd St
Los Angeles, CA 90057-1944
Mailing address
2100 W 3Rd St Ste 200
Los Angeles, CA 90057-1993
Phone (323) 629-7066
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20191111001757 | CA | Order and Referring Only - Clinical Social Worker | 5890058259 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 79279 | CA | MD | Marriage & Family Therapist |
| 33817 | CA | MD | Licensed Psychiatric Technician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Healing Clinical Counseling Center, Inc | Current | Accepting new patients |
Networks
- BSC 65 PLUS INDIVIDUAL MAPD
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Marriage & Family Therapist
- Los Angeles, CA
- NPI 1740827815
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1357603200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1616457600000",
"number": "1407193667",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2100 W 3RD ST STE 200",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900571993",
"telephone_number": "323-629-7066"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2100 W 3RD ST",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900571944",
"telephone_number": "323-269-7066"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VALLADARES",
"first_name": "ADA",
"middle_name": "M",
"name_prefix": "Miss",
"credential": "MSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-01-08",
"last_updated": "2021-03-23",
"certification_date": "2021-01-28",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "CA",
"license": "79279",
"primary": false
},
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "CA",
"license": "33817",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Los Angeles, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.