Individual provider Active NPI

Valerie Diane Perry, LCSW

  • Clinical Social Worker
  • Bentonville, AR
National Provider Identifier
1932398617
Registry record updated Aug 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
C-1018 Issued in AR
Practice address
809 SE 28TH St Ste 1
Bentonville, AR 72712-4268
Phone
(479) 876-8626
Fax
(479) 876-8636
NPI assigned
Oct 18, 2007
Last updated
Aug 13, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 13, 2025

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 C-1018 AR Primary

Addresses

Primary practice location

809 SE 28TH St Ste 1
Bentonville, AR 72712-4268

Mailing address

809 SE 28TH St Ste 1
Bentonville, AR 72712-4268
Phone (479) 876-8626

Other practice location 1

2400 S 48th St
Springdale, AR 72762-6683
Phone (479) 750-2020

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
I20121025000315 AR Practitioner - Clinical Social Worker 5991955031 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

809 SE 28TH St
Suite 1
Bentonville, AR 72712-4268
Phone (479) 876-8626

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
C-1018ARMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Texarkana Behavioral Associates, L.C. CurrentSince Aug 20, 2012 Accepting new patients
Texarkana Behavioral Associates, L.C. Current Accepting new patients
Texarkana Behavioral Associates, L.C. CurrentSince Aug 20, 2012 Accepting new patients
John L. Shasteen LLC Clinical Past Accepting new patients

Locations

815 Fort St
Ste A
Barling, AR 72923
Phone (479) 494-5740

4253 N Crossover Rd
Fayetteville, AR 72703
Phone (479) 443-6496

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1192665600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755043200000",
    "number": "1932398617",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "809 SE 28TH ST STE 1",
            "city": "BENTONVILLE",
            "state": "AR",
            "postal_code": "727124268",
            "telephone_number": "479-876-8626",
            "fax_number": "479-876-8636"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "809 SE 28TH ST STE 1",
            "city": "BENTONVILLE",
            "state": "AR",
            "postal_code": "727124268",
            "telephone_number": "479-876-8626",
            "fax_number": "479-876-8636"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2400 S 48th St",
            "address_purpose": "LOCATION",
            "city": "Springdale",
            "state": "AR",
            "postal_code": "727626683",
            "country_code": "US",
            "telephone_number": "479-750-2020",
            "fax_number": "479-872-2441",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PERRY",
        "first_name": "VALERIE",
        "middle_name": "DIANE",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-10-18",
        "last_updated": "2025-08-13",
        "certification_date": "2025-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "AR",
            "license": "C-1018",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bentonville, AR

Sources for this page

Verify at the official NPI Registry.