Active NPI
Pamela Viletta Stover, LCSW
- Clinical Social Worker
- Huntington, IN
National Provider Identifier
1841625035
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 34007467A
- Practice address
- 1740 E 67 N
Lot 57 B
Huntington, IN 46750 - Phone
- (219) 386-3600
- Fax
- (219) 386-3660
- NPI assigned
- Sep 6, 2013
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 57798 | TX | |
| Clinical Social Worker | 1041C0700X | 34007467A | IN | Primary |
Addresses
Primary practice location
1740 E 67 N
Lot 57 B
Huntington, IN 46750
Mailing address
PO Box 166
Kouts, IN 46347-0166
Phone (219) 281-6163
Other practice location 1
2004 Valparaiso St
Valparaiso, IN 46383-3138
Phone (219) 477-5646 ext. 105
Other practice location 2
402 S State Road 49
Valparaiso, IN 46383-7858
Phone (219) 281-6163
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 300045162 | Medicaid | IN |
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 34007467A | IN | MD | Clinical Social Worker |
| 57798 | TX | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1378425600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1610064000000",
"number": "1841625035",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 166",
"city": "KOUTS",
"state": "IN",
"postal_code": "463470166",
"telephone_number": "219-281-6163",
"fax_number": "219-386-3600"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1740 E 67 N",
"address_2": "LOT 57 B",
"city": "HUNTINGTON",
"state": "IN",
"postal_code": "46750",
"telephone_number": "219-386-3600",
"fax_number": "219-386-3660"
}
],
"practiceLocations": [
{
"address_1": "2004 Valparaiso St",
"address_purpose": "LOCATION",
"city": "Valparaiso",
"state": "IN",
"postal_code": "463833138",
"country_code": "US",
"telephone_number": "219-477-5646 x105",
"fax_number": "219-476-3190",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "402 S State Road 49",
"address_purpose": "LOCATION",
"city": "Valparaiso",
"state": "IN",
"postal_code": "463837858",
"country_code": "US",
"telephone_number": "219-281-6163",
"fax_number": "219-386-3600",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "STOVER",
"first_name": "PAMELA",
"middle_name": "VILETTA",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-09-06",
"last_updated": "2021-01-08",
"certification_date": "2020-12-31",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "TX",
"license": "57798",
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "IN",
"license": "34007467A",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "300045162",
"state": "IN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Huntington, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.