Kathryn Amanda Lidgard, LSWAIC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

SC60970292 Issued in WA

Practice address

2100 24TH Ave S Ste 260
Seattle, WA 98144-4644

Phone

(206) 715-6051

NPI assigned

Oct 10, 2017

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in WA

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

Specialty

Clinical Social Worker

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Providence Health and Services- WashingtonGroup PAC ID 8325100480, 527 clinicians

Practice addresses (Care Compare)

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 and National Provider Directory roles.

• Providence Health & Services- Washington

  • General Practice Physician
  • Everett, WA
  • NPI 1124270715

  Clinical

  Medicare reassignment Care Compare group NPD
• Special Service for Groups, Inc.

  • Adolescent and Children Mental Health Clinic/Center
  • Los Angeles, CA
  • NPI 1982735932
  NPD (past)

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

{
    "created_epoch": "1507593600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1564963200000",
    "number": "1003326646",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2100 24TH AVE S STE 260",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981444644",
            "telephone_number": "206-715-6051"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2100 24TH AVE S STE 260",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981444644",
            "telephone_number": "206-715-6051"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5715 S Broadway",
            "address_purpose": "LOCATION",
            "city": "Los Angeles",
            "state": "CA",
            "postal_code": "900374131",
            "country_code": "US",
            "telephone_number": "323-948-0444",
            "fax_number": "323-948-0443",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "19401 S Vermont Ave Ste A200",
            "address_purpose": "LOCATION",
            "city": "Torrance",
            "state": "CA",
            "postal_code": "90502",
            "country_code": "US",
            "telephone_number": "310-323-6887",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LIDGARD",
        "first_name": "KATHRYN",
        "middle_name": "AMANDA",
        "credential": "LSWAIC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-10-10",
        "last_updated": "2019-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WA",
            "license": "SC60970292",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Julia Liddane, PA-C
• Marti Liddell, M.D.
• Katelyn Amicia Liddle
• Dominique Liddy, MD
• Benjamin Lidgard, M.D.
• Aliza Silka Lieb
• Sarah Kay Lieb, B.D.
• Claire Gertrude Lieberman, RD,
• Daniel Aaron Lieberman, MD
• James R Lieberman, M.D.

• Clinical Social Worker in Seattle, WA
• Providers in Seattle, 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 Aug 5, 2019; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.