Raquel Pulliam

Primary specialty

Social WorkerTaxonomy code 104100000X

License

149.031303 Issued in IL

Practice address

4202 Williamson PL Ste 1
Mount Vernon, IL 62864-6760

Phone

(618) 816-1224

NPI assigned

Jul 18, 2023

Last updated

May 21, 2026By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Stress & Trauma Treatment Center, Inc.

  • Adolescent and Children Mental Health Clinic/Center
  • Eldorado, IL
  • NPI 1851966014
  NPD
• Dynamic Counseling and Consultation Services

  • Clinical Social Worker
  • Mount Vernon, IL
  • NPI 1457771677
  NPD (past)
• Stress & Trauma Treatment Center

  • Clinical Child & Adolescent Psychologist
  • Eldorado, IL
  • NPI 1700342532
  NPD (past)

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

{
    "created_epoch": "1689638400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1779321600000",
    "number": "1669152450",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1111 S LINCOLN AVE UNIT 1326",
            "city": "O FALLON",
            "state": "IL",
            "postal_code": "622695165",
            "telephone_number": "618-816-1224"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4202 WILLIAMSON PL STE 1",
            "city": "MOUNT VERNON",
            "state": "IL",
            "postal_code": "628646760",
            "telephone_number": "618-816-1224"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PULLIAM",
        "first_name": "RAQUEL",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-07-18",
        "last_updated": "2026-05-21",
        "certification_date": "2026-05-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "IL",
            "license": "149.031303",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• James E. Probst Jr., D.O.
• Professional Imaging Consultants, PC
• Progressive Housing, Inc.
• Prompt Care
• Melissa Pryer, RD
• Osman Javed Qaiyum, M.D.
• Kent S Quinn, MD
• Glenda Ann Raby, MS., CCC-SLP
• David Peter Rakey, CRNA
• Bryon Theron Ramos, ATC, CSCS

• Social Worker in Mount Vernon, IL
• Providers in Mount Vernon, IL by specialty
• Social Worker in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2026; 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.