Larissa D Peay, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

LW 00009158 Issued in WA

Practice address

310 3Rd Ave NE Ste 105
Issaquah, WA 98027-3345

Phone

(801) 209-4198

NPI assigned

Dec 22, 2008

Last updated

Mar 6, 2023By 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

Opted out of Medicare

Yes, effective Dec 17, 2019 through Dec 17, 2027

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• LDS Family Services

  • Community/Behavioral Health Agency
  • Renton, WA
  • NPI 1184974362
  NPD (past)

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

{
    "created_epoch": "1229904000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678060800000",
    "number": "1003052044",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "310 3RD AVE NE STE 105",
            "city": "ISSAQUAH",
            "state": "WA",
            "postal_code": "980273345",
            "telephone_number": "801-209-4198"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "310 3RD AVE NE STE 105",
            "city": "ISSAQUAH",
            "state": "WA",
            "postal_code": "980273345",
            "telephone_number": "801-209-4198"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEAY",
        "first_name": "LARISSA",
        "middle_name": "D",
        "name_prefix": "Ms.",
        "credential": "LICSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-12-22",
        "last_updated": "2023-03-06",
        "certification_date": "2023-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WA",
            "license": "LW 00009158",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Peak Retina PLLC
• Peak Sports and Spine PT-Issaquah P S
• Madison Isabel Pearl, M.A., BCBA, LBA
• Arianna Cheyenn Pearman
• Kelsey Pearson, PA-C
• Ron Pechmagre, LMT
• Pediatric Associates, Inc., P.S. Dba Allegro Pediatrics (Pine Lake)
• Pediatric Speech & Lang Assocs
• Frida Rineth Pena Benitez, MD
• Juanjuan Peng

• Clinical Social Worker in Issaquah, WA
• Providers in Issaquah, WA by specialty
• Clinical Social Worker in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2023; 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.