NPIMap

Individual provider Active NPI

Kisha Nathima Vallejo, LCSW

  • Social Worker
  • Killeen, TX
National Provider Identifier
1497227201
Registry record updated Mar 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
65621 Issued in TX
Practice address
1103 West Stan Schlueter Loop
Building a Suite 100
Killeen, TX 76549
Phone
(254) 213-7847
Fax
(254) 312-2002
NPI assigned
Dec 19, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 13, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 65621 TX Primary

Addresses

Primary practice location

1103 West Stan Schlueter Loop
Building a Suite 100
Killeen, TX 76549

Mailing address

1103 West Stan Schlueter Loop
Building a Suite 100
Killeen, TX 76549
Phone (254) 213-7847

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
65621TXMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Family Endeavors, Inc Past Accepting new patients
Yellow Ribbon Counseling PLLC Past Accepting new patients
Family Endeavors, Inc Past Accepting new patients

Organizations & group practices 3

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": "1545177600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741824000000",
    "number": "1497227201",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1103 WEST STAN SCHLUETER LOOP",
            "address_2": "BUILDING A SUITE 100",
            "city": "KILLEEN",
            "state": "TX",
            "postal_code": "76549",
            "telephone_number": "254-213-7847",
            "fax_number": "254-312-2002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1103 WEST STAN SCHLUETER LOOP",
            "address_2": "BUILDING A SUITE 100",
            "city": "KILLEEN",
            "state": "TX",
            "postal_code": "76549",
            "telephone_number": "254-213-7847",
            "fax_number": "254-312-2002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VALLEJO",
        "first_name": "KISHA",
        "middle_name": "NATHIMA",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-12-19",
        "last_updated": "2025-03-13",
        "certification_date": "2025-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "TX",
            "license": "65621",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Killeen, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2025; 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.