Susan Kosche Vallem, EDD, LISW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

02281 Issued in IA

Practice address

106 16TH St SW
Waverly, IA 50677-2822

Phone

(319) 504-9050

NPI assigned

Jun 28, 2013

Last updated

Jun 28, 2013By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1372377600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1372377600000",
    "number": "1932549334",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "106 16TH ST SW",
            "city": "WAVERLY",
            "state": "IA",
            "postal_code": "506772822",
            "telephone_number": "319-504-9050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "106 16TH ST SW",
            "city": "WAVERLY",
            "state": "IA",
            "postal_code": "506772822",
            "telephone_number": "319-504-9050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VALLEM",
        "first_name": "SUSAN",
        "middle_name": "KOSCHE",
        "name_prefix": "Dr.",
        "credential": "EDD, LISW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-06-28",
        "last_updated": "2013-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IA",
            "license": "02281",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Larissa Lee Treloar, SLP
• Cam Turner
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• Christopher Michael Utz, LPT
• Devin Van Raden
• Larry H Vandaalen, OD
• Kerri Marie Vanee, ACNP-BC
• Paula Jean Vaughan, MBA, RD, LD
• Rachel Lee Vaughn, ARNP

• Clinical Social Worker in Waverly, IA
• Providers in Waverly, IA by specialty
• Clinical Social Worker in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.