Active NPI
Jane Walsma, LCSW
- School Social Worker
- Valley Park, MO
National Provider Identifier
1679941512
On this page
Key facts
NPPES NPI Registry- Primary specialty
- School Social Worker
- License
- 004679
- Practice address
- 1 Main St
Valley Park, MO 63088-1573 - Phone
- (636) 923-3654
- Fax
- (636) 225-4518
- NPI assigned
- Sep 9, 2015
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| School Social Worker | 1041S0200X | 004679 | MO | Primary |
Addresses
Primary practice location
1 Main St
Valley Park, MO 63088-1573
Mailing address
12110 Clayton Rd
Saint Louis, MO 63131-2516
Phone (636) 923-3654
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
| License | State | Type | Specialty |
|---|---|---|---|
| 004679 | MO | MD | School Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1441756800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1441756800000",
"number": "1679941512",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12110 CLAYTON RD",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631312516",
"telephone_number": "636-923-3654",
"fax_number": "636-225-4518"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1 MAIN ST",
"city": "VALLEY PARK",
"state": "MO",
"postal_code": "630881573",
"telephone_number": "636-923-3654",
"fax_number": "636-225-4518"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WALSMA",
"first_name": "JANE",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-09-09",
"last_updated": "2015-09-09",
"status": "A"
},
"taxonomies": [
{
"code": "1041S0200X",
"taxonomy_group": "",
"desc": "Social Worker, School",
"state": "MO",
"license": "004679",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Valley Park, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.