Individual provider Active NPI

Ada M Valladares, MSW

  • Mental Health Counselor
  • Los Angeles, CA
National Provider Identifier
1407193667
Registry record updated Mar 23, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
33817 Issued in CA
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

Updated by the provider on Mar 23, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20191111001757 CA Order and Referring Only - Clinical Social Worker 5890058259

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
79279CAMDMarriage & Family Therapist
33817CAMDLicensed Psychiatric Technician

Practice roles

OrganizationSpecialtyStatusNew 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.

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

Verify at the official NPI Registry.