Individual provider Active NPI

Iris M Vallier, LCSW

  • Clinical Social Worker
  • Fishers, IN
National Provider Identifier
1700968534
Registry record updated Jun 27, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
34003068A Issued in IN
Practice address
11205 Delight Creek Rd
Fishers, IN 46038-4639
Phone
(317) 596-0758
NPI assigned
Oct 20, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 27, 2012

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 39001058A IN
Clinical Social Worker 1041C0700X 34003068A IN Primary
Marriage & Family Therapist 106H00000X 35000380A IN

Addresses

Primary practice location

11205 Delight Creek Rd
Fishers, IN 46038-4639

Mailing address

11205 Delight Creek Rd
Fishers, IN 46038-4639
Phone (317) 596-0758

Other identifiers 1

IdentifierTypeStateIssuer
100270530AMedicaidIN

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

LicenseStateTypeSpecialty
39001058AINMDMental Health Counselor
34003068AINMDClinical Social Worker
35000380AINMDMarriage & Family Therapist

NPI Registry JSON

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

{
    "created_epoch": "1161302400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1340755200000",
    "number": "1700968534",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11205 DELIGHT CREEK RD",
            "city": "FISHERS",
            "state": "IN",
            "postal_code": "460384639",
            "telephone_number": "317-596-0758"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11205 DELIGHT CREEK RD",
            "city": "FISHERS",
            "state": "IN",
            "postal_code": "460384639",
            "telephone_number": "317-596-0758"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VALLIER",
        "first_name": "IRIS",
        "middle_name": "M",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-20",
        "last_updated": "2012-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "IN",
            "license": "39001058A",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IN",
            "license": "34003068A",
            "primary": true
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "IN",
            "license": "35000380A",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100270530A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fishers, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2012; 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.