Amy Vallem, MSW, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

149018550 Issued in IL

Practice address

8 Eagle Ctr Ste 15
O Fallon, IL 62269-1947

Phone

(618) 207-3543

Fax

(855) 813-0212

NPI assigned

Jul 3, 2016

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Jan 15, 2021 through Jan 15, 2027

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Ofallon Counseling Services LLC

  • Clinical Social Worker
  • O Fallon, IL
  • NPI 1225690001
  NPD (past) Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1467504000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560470400000",
    "number": "1659723591",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1180 TAZEWELL DR",
            "city": "O FALLON",
            "state": "IL",
            "postal_code": "622697149",
            "telephone_number": "618-799-9737"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8 EAGLE CTR STE 15",
            "city": "O FALLON",
            "state": "IL",
            "postal_code": "622691947",
            "telephone_number": "618-207-3543",
            "fax_number": "855-813-0212"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "21 S 6th St",
            "address_purpose": "LOCATION",
            "city": "Wood River",
            "state": "IL",
            "postal_code": "620952107",
            "country_code": "US",
            "telephone_number": "618-216-3907",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4972 Benchmark Centre Dr Ste 100",
            "address_purpose": "LOCATION",
            "city": "Swansea",
            "state": "IL",
            "postal_code": "622262070",
            "country_code": "US",
            "telephone_number": "618-799-9737",
            "fax_number": "618-744-7301",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VALLEM",
        "first_name": "AMY",
        "credential": "MSW, LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-07-03",
        "last_updated": "2019-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149018550",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Upcare LLC
• Urology of St. Louis, Inc.
• Usc Telehealth
• Adaku Mennwa Uzo-Okereke, M.D.
• Taylor Nicole Valentine
• Marlon Van Ham
• Michael Vanantwerp, MD
• Nicole Vandelinde
• Bethany Varel
• Mary Varel, CCC-SLP

• Clinical Social Worker in O Fallon, IL
• Providers in O Fallon, IL by specialty
• Clinical Social Worker in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2019; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.