Individual provider Active NPI

Shandrieka Poree Vallare

  • Social Worker
  • New Orleans, LA
National Provider Identifier
1578936985
Registry record updated Jul 12, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
13313 Issued in LA
Practice address
2626 Canal St
New Orleans, LA 70119-6400
Phone
(504) 525-2366
NPI assigned
Nov 6, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 12, 2022

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 13313 LA Primary

Addresses

Primary practice location

2626 Canal St
New Orleans, LA 70119-6400

Mailing address

20619 Flintoff LN
Katy, TX 77449-0403
Phone (504) 722-6796

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20220713002344 TX Practitioner - Clinical Social Worker 3173904752 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Thrive Counseling LLCGroup PAC ID 0749458420, 1,187 clinicians

Practice addresses (Care Compare)

16310 Tomball Pkwy
Suite 104
Houston, TX 77064-1814
Phone (855) 284-7483

23410 Grand Reserve Dr
Suite 301
Katy, TX 77494-4989
Phone (855) 284-7483

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
13313LAMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Thrive Counseling LLC CurrentSince Jun 3, 2022 Accepting new patients
Shine Medical Providers PC Past Accepting new patients

Locations

1000 Post and Paddock St
Ste 102
Grand Prairie, TX 75050

16310 Tomball Pkwy
Ste 104
Houston, TX 77064
Phone (210) 864-1420

Organizations & group practices 2

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": "1446768000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1657584000000",
    "number": "1578936985",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20619 FLINTOFF LN",
            "city": "KATY",
            "state": "TX",
            "postal_code": "774490403",
            "telephone_number": "504-722-6796"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2626 CANAL ST",
            "city": "NEW ORLEANS",
            "state": "LA",
            "postal_code": "701196400",
            "telephone_number": "504-525-2366"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VALLARE",
        "first_name": "SHANDRIEKA",
        "middle_name": "POREE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-11-06",
        "last_updated": "2022-07-12",
        "certification_date": "2022-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "LA",
            "license": "13313",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Orleans, LA

Sources for this page

Verify at the official NPI Registry.