Individual provider Active NPI

Valerie D Whitlock, LCSW

  • Clinical Social Worker
  • Trumann, AR
National Provider Identifier
1770638355
Registry record updated Oct 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
2091-C Issued in AR
Practice address
119 Highway 463 S
Trumann, AR 72472-2604
Phone
(870) 819-1876
NPI assigned
Jan 24, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 1, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 2091-C AR Primary

Addresses

Primary practice location

119 Highway 463 S
Trumann, AR 72472-2604

Mailing address

119 Highway 463 S
Trumann, AR 72472-2604
Phone (870) 819-1876

Other identifiers 2

IdentifierTypeStateIssuer
227728719MedicaidAR
5R939OtherARBCBS

Other names 1

  • Valerie D Brannen Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR
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 1

Enrollment IDStateProvider typePAC IDDetails
I20100312000325 AR Practitioner - Clinical Social Worker 9931234218 Reassigns benefits to 2 organizations
Practice locations: Trumann, AR

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

119 Hwy 463 S
Trumann, AR 72472-2604
Phone (870) 819-1876

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Families, Inc of Arkansas Mental Health CurrentSince Feb 4, 2010 Accepting new patients
Delta Behavioral Health, LLC CurrentSince Dec 18, 2019 Accepting new patients
Families, Inc. of Arkansas Mental Health CurrentSince Feb 4, 2010 Accepting new patients

Locations

1815 Pleasant Grove Rd
Jonesboro, AR 72405
Phone (870) 833-6886

603 W Fleeman
Ste 4
Manila, AR 72442
Phone (870) 570-0358

920 Medical Dr
Manila, AR 72442
Phone (870) 570-0358

1425 W Main St
Walnut Ridge, AR 72476
Phone (870) 886-5303

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1169596800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727740800000",
    "number": "1770638355",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "119 HIGHWAY 463 S",
            "city": "TRUMANN",
            "state": "AR",
            "postal_code": "724722604",
            "telephone_number": "870-819-1876",
            "fax_number": "870-418-1069"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "119 HIGHWAY 463 S",
            "city": "TRUMANN",
            "state": "AR",
            "postal_code": "724722604",
            "telephone_number": "870-819-1876"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHITLOCK",
        "first_name": "VALERIE",
        "middle_name": "D",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-24",
        "last_updated": "2024-10-01",
        "certification_date": "2024-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "AR",
            "license": "2091-C",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "227728719",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "5R939",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "VALERIE",
            "last_name": "BRANNEN",
            "middle_name": "D",
            "credential": "LCSW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Trumann, AR

Sources for this page

Verify at the official NPI Registry.