Active NPI
Elideth O'Dell
- Clinical Social Worker
- Tacoma, WA
National Provider Identifier
1013407436
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- LCSW-4913
- Practice address
- 9040A Jackson Ave
Tacoma, WA 98431-3602 - Phone
- (253) 968-1110
- NPI assigned
- May 10, 2018
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | HI | ||
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Clinical Social Worker | 1041C0700X | LCSW-4913 | HI | Primary |
Addresses
Primary practice location
9040A Jackson Ave
Tacoma, WA 98431-3602
Mailing address
91-2301 Old Ft Weaver Rd
Ewa Beach, HI 96706-3602
Phone (808) 671-8511
Other practice location 1
1149 S Hill St Ste H-375
Los Angeles, CA 90015-2212
Phone (213) 821-5977
Other practice location 2
91-2301 Fort Weaver Rd
Ewa Beach, HI 96706-3602
Phone (808) 677-2819
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LCSW-4913 | HI | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1525910400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1748304000000",
"number": "1013407436",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "91-2301 OLD FT WEAVER RD",
"city": "EWA BEACH",
"state": "HI",
"postal_code": "967063602",
"telephone_number": "808-671-8511"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9040A JACKSON AVE",
"city": "TACOMA",
"state": "WA",
"postal_code": "984313602",
"telephone_number": "253-968-1110"
}
],
"practiceLocations": [
{
"address_1": "1149 S Hill St Ste H-375",
"address_purpose": "LOCATION",
"city": "Los Angeles",
"state": "CA",
"postal_code": "900152212",
"country_code": "US",
"telephone_number": "213-821-5977",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "91-2301 Fort Weaver Rd",
"address_purpose": "LOCATION",
"city": "Ewa Beach",
"state": "HI",
"postal_code": "967063602",
"country_code": "US",
"telephone_number": "808-677-2819",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "O'DELL",
"first_name": "ELIDETH",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-05-10",
"last_updated": "2025-05-27",
"certification_date": "2025-05-27",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "HI",
"license": null,
"primary": false
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "HI",
"license": "LCSW-4913",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tacoma, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.