Theresa Jean Valerio, LCSW

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

L2787 Issued in OR

Practice address

2200 E Ellendale Ave
Dallas, OR 97338-9353

Phone

(503) 623-5588

Fax

(503) 623-4729

NPI assigned

May 7, 2007

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

Opted out of Medicare

Yes, effective Oct 18, 2022 through Oct 18, 2026

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Eola Mental Health Services

  • Mental Health Counselor
  • Dallas, OR
  • NPI 1801932868
  NPD (past)
• Polk Adolescent Day Treatment Center Inc

  • Community/Behavioral Health Agency
  • Dallas, OR
  • NPI 1922175496
  NPD (past)

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

{
    "created_epoch": "1178496000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1972716108",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2200 E ELLENDALE AVE",
            "city": "DALLAS",
            "state": "OR",
            "postal_code": "973389353",
            "telephone_number": "503-623-5588",
            "fax_number": "503-623-4729"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2200 E ELLENDALE AVE",
            "city": "DALLAS",
            "state": "OR",
            "postal_code": "973389353",
            "telephone_number": "503-623-5588",
            "fax_number": "503-623-4729"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VALERIO",
        "first_name": "THERESA",
        "middle_name": "JEAN",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-07",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "OR",
            "license": "L2787",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• William A. Tice
• Sergiu Todor
• Devin Phillip Torrez
• Shannon Isabelle Vajretti, QMHA
• David Valencia
• Lynn Vanallen, LMT
• Rolf Jett Vognild, MSPT
• Cheryl Lynn Voigt, RN
• Reva Min Vrana, NP
• Larry J Vuylsteke

• Mental Health Counselor in Dallas, OR
• Providers in Dallas, OR by specialty
• Mental Health Counselor in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.