Individual provider Active NPI

Oliver Birchwood-Glover, LCSW

  • Clinical Social Worker
  • Walla Walla, WA
National Provider Identifier
1013116193
Registry record updated Nov 8, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LCSW - 992649 Issued in CO
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, 2018By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 8, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
2010913MedicaidWA

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
Green means eligible to order or refer.

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

LicenseStateTypeSpecialty
LCSW - 992649COMDClinical 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

Verify at the official NPI Registry.