Richelle L Vanburen-Walls, LSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

12473 Issued in LA

Practice address

15301 Warren Shingle Rd
Beale AFB, CA 95903-1905

Phone

(530) 634-4662

NPI assigned

Jan 12, 2011

Last updated

Nov 25, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in LA

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Upward Health of la Professional Medical Corporation

  • General Practice Physician
  • New Orleans, LA
  • NPI 1750120119
  Medicare reassignment NPD
• Merakey Pennsylvania

  • Community/Behavioral Health Agency
  • Lafayette, LA
  • NPI 1033484019
  Medicare reassignment
• Eleanor Health Professional la, LLC

  • Addiction Medicine (Psychiatry & Neurology) Physician
  • Lafayette, LA
  • NPI 1265050736
  NPD
• Merakey Pennsylvania

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Baton Rouge, LA
  • NPI 1467252536
  NPD
• Merakey Pennsylvania

  • Community/Behavioral Health Agency
  • Monroe, LA
  • NPI 1740789312
  NPD
• Merakey Pennsylvania

  • Community/Behavioral Health Agency
  • New Orleans, LA
  • NPI 1992079909
  NPD
• Upward Health of Louisiana LLC

  • General Practice Physician
  • New Orleans, LA
  • NPI 1871144725
  NPD

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

{
    "created_epoch": "1294790400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732492800000",
    "number": "1871898437",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "221 CRESCENT ST STE 202",
            "city": "WALTHAM",
            "state": "MA",
            "postal_code": "024533425",
            "telephone_number": "781-487-1107",
            "fax_number": "919-765-8657"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15301 WARREN SHINGLE RD",
            "city": "BEALE AFB",
            "state": "CA",
            "postal_code": "959031905",
            "telephone_number": "530-634-4662"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANBUREN-WALLS",
        "first_name": "RICHELLE",
        "middle_name": "L",
        "credential": "LSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-01-12",
        "last_updated": "2024-11-25",
        "certification_date": "2024-11-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "ND",
            "license": "4488",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WA",
            "license": "LW61300559",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "LA",
            "license": "12473",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "74153",
            "state": "ND"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Rebecca Lynne Thompson, LCSW
• Grant Tong, PT
• Tora Jean Tornbom, MD
• Vladimir Vader, DMD
• Jeffrey M Van Ness, DMD
• Lijah Vann Gardner, DO
• Paul D Vu, M.D.
• Zachary Wajvoda, PA-C
• Wesley Wander, D.O.
• Kelly Neil West, M.D.

• Clinical Social Worker in Beale AFB, CA
• Providers in Beale AFB, CA by specialty
• Clinical Social Worker in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 25, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.