Individual provider Active NPI

Valerie Sue Brandal, PSYD, LMSW, LISW-S

  • Clinical Social Worker
  • Perrysburg, OH
National Provider Identifier
1619396603
Registry record updated Oct 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
I.2102932-SUPV Issued in OH
Practice address
900 W South Boundary St BLDG 7B
Perrysburg, OH 43551-5244
Phone
(419) 724-7233
Fax
(877) 622-7635
NPI assigned
Apr 7, 2014
Last updated
Oct 7, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 7, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 6801085300 MI
Clinical Social Worker 1041C0700X I.2102932-SUPV OH Primary

Addresses

Primary practice location

900 W South Boundary St BLDG 7B
Perrysburg, OH 43551-5244

Mailing address

4041 W Sylvania Ave
Ste LL2
Toledo, OH 43623-4464
Phone (231) 878-9198

Other practice location 1

4041 W Sylvania Ave
Ste LL2
Toledo, OH 43623-4464
Phone (419) 724-4233

Other identifiers 1

IdentifierTypeStateIssuer
0455026MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI, OH2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20140423002308 MI Practitioner - Clinical Social Worker 4789817917 Practice locations: Monroe, MI
I20210720000523 OH Practitioner - Clinical Social Worker 4789817917 Reassigns benefits to 1 organization
Practice locations: Toledo, OH

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hope Christian Counseling CenterGroup PAC ID 4587086244, 2 clinicians

Practice addresses (Care Compare)

900 W S Boundary St
BLDG 7B
Perrysburg, OH 43551-5244
Phone 4197244233102

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6801085300MIMDClinical Social Worker
I.2102932-SUPVOHMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Hope Christian Counseling Center Clinical CurrentSince Jul 23, 2021 Accepting new patients

Locations

900 W South Boundary St
Bldg 7B
Perrysburg, OH 43551
Phone (419) 724-4233

4041 W Sylvania Ave
Ste LL2
Toledo, OH 43623
Phone (419) 704-2938

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, 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": "1396828800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728259200000",
    "number": "1619396603",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4041 W SYLVANIA AVE",
            "address_2": "STE LL2",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436234464",
            "telephone_number": "231-878-9198"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 W SOUTH BOUNDARY ST BLDG 7B",
            "city": "PERRYSBURG",
            "state": "OH",
            "postal_code": "435515244",
            "telephone_number": "419-724-7233",
            "fax_number": "877-622-7635"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4041 W SYLVANIA AVE",
            "address_2": "STE LL2",
            "address_purpose": "LOCATION",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436234464",
            "country_code": "US",
            "telephone_number": "419-724-4233",
            "fax_number": "877-622-7635",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BRANDAL",
        "first_name": "VALERIE",
        "middle_name": "SUE",
        "name_prefix": "Dr.",
        "credential": "PSYD, LMSW, LISW-S",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-04-07",
        "last_updated": "2024-10-07",
        "certification_date": "2024-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801085300",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "I.2102932-SUPV",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0455026",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Perrysburg, OH

Sources for this page

Verify at the official NPI Registry.