Active NPI
Oliver Birchwood-Glover, LCSW
- Clinical Social Worker
- Walla Walla, WA
National Provider Identifier
1013116193
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- LCSW - 992649
- Practice address
- 409 E Sumach St Ste 4
Walla Walla, WA 99362 - Phone
- (509) 540-4090
- NPI assigned
- Jul 17, 2007
- Last updated
- Nov 8, 2018
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | |||
| Clinical Social Worker | 1041C0700X | LCSW - 992649 | CO | Primary |
Addresses
Primary practice location
409 E Sumach St Ste 4
Walla Walla, WA 99362
Mailing address
13 1/2 E Main St
Suite 214
Walla Walla, WA 99362-1950
Phone (509) 525-1750
Other practice location 1
13 1/2 E Main St
Suite 214
Walla Walla, WA 99362-1950
Phone (509) 525-1750
Other practice location 2
534 S 3rd Ave Apt 101
Walla Walla, WA 99362-2712
Phone (509) 525-0704
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2010913 | Medicaid | WA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Social Worker
- Education
- Other, 1993
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
1800 Cooper Point Rd SW
Suite 22
Olympia, WA 98502-1179
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LCSW - 992649 | CO | MD | Clinical Social Worker |
Networks
- WA PPO C-SNP
- devoted network organization-83621310-88c0-4660-8f8d-b8ea8f4dc04e
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1184630400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1541635200000",
"number": "1013116193",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "13 1/2 E MAIN ST",
"address_2": "SUITE 214",
"city": "WALLA WALLA",
"state": "WA",
"postal_code": "993621950",
"telephone_number": "509-525-1750",
"fax_number": "509-525-1606"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "409 E SUMACH ST STE 4",
"city": "WALLA WALLA",
"state": "WA",
"postal_code": "99362",
"telephone_number": "509-540-4090"
}
],
"practiceLocations": [
{
"address_1": "13 1/2 E Main St",
"address_2": "Suite 214",
"address_purpose": "LOCATION",
"city": "Walla Walla",
"state": "WA",
"postal_code": "993621950",
"country_code": "US",
"telephone_number": "509-525-1750",
"fax_number": "509-525-1606",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "534 S 3rd Ave Apt 101",
"address_purpose": "LOCATION",
"city": "Walla Walla",
"state": "WA",
"postal_code": "993622712",
"country_code": "US",
"telephone_number": "509-525-0704",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "BIRCHWOOD-GLOVER",
"first_name": "OLIVER",
"credential": "LCSW",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-07-17",
"last_updated": "2018-11-08",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": null,
"license": null,
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "CO",
"license": "LCSW - 992649",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "2010913",
"state": "WA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Walla Walla, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2018; 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.