Individual provider Active NPI

Valeta Wilson, LSW

  • Social Worker
  • East Chicago, IN
National Provider Identifier
1871833103
Registry record updated Feb 23, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
33006279A Issued in IN
Practice address
4009 Melville Ave
East Chicago, IN 46312-2735
Phone
(219) 805-2941
NPI assigned
Feb 23, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 23, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 33006279A IN Primary

Addresses

Primary practice location

4009 Melville Ave
East Chicago, IN 46312-2735

Mailing address

4009 Melville Ave
East Chicago, IN 46312-2735
Phone (219) 805-2941

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN, IL2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20150715001287 IN Practitioner - Clinical Social Worker 0042523326 Reassigns benefits to 2 organizations
I20240422001621 IL Practitioner - Clinical Social Worker 0042523326 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
33006279AINMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Sondermind Provider Network LLC CurrentSince Sep 21, 2023 Accepting new patients
Grow Healthcare Group PA CurrentSince Nov 9, 2023 Accepting new patients

Locations

66 W Flagler St
Ste 900
Miami, FL 33130
Phone (786) 244-7711

605 N Michigan Ave
Fl 4
Chicago, IL 60611
Phone (773) 232-5338

9465 Counselors Row
Ste 200
Indianapolis, IN 46240
Phone (463) 220-4646

333 N Alabama St
Ste 350
Indianapolis, IN 46204
Phone (317) 983-0002

Organizations & group practices 2

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": "1361577600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1361577600000",
    "number": "1871833103",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4009 MELVILLE AVE",
            "city": "EAST CHICAGO",
            "state": "IN",
            "postal_code": "463122735",
            "telephone_number": "219-805-2941"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4009 MELVILLE AVE",
            "city": "EAST CHICAGO",
            "state": "IN",
            "postal_code": "463122735",
            "telephone_number": "219-805-2941"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "VALETA",
        "name_prefix": "Mrs.",
        "credential": "LSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-02-23",
        "last_updated": "2013-02-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "IN",
            "license": "33006279A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in East Chicago, IN

Sources for this page

Verify at the official NPI Registry.