Individual provider Active NPI

Paulette M Caswell, LICSW

  • Clinical Social Worker
  • Mountlake Terrace, WA
National Provider Identifier
1013440510
Registry record updated Apr 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LW60173119 Issued in WA
Practice address
21907 64TH Ave W Ste 200
Mountlake Terrace, WA 98043-6200
Phone
(425) 640-7009
NPI assigned
Apr 11, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X LW60173119 WA Primary

Addresses

Primary practice location

21907 64TH Ave W Ste 200
Mountlake Terrace, WA 98043-6200

Mailing address

PO Box 13306
Mill Creek, WA 98082-1306
Phone (425) 686-8664

Other practice location 1

23210 9th Pl W
Bothell, WA 98021-7310
Phone (206) 406-9243

Other identifiers 2

IdentifierTypeStateIssuer
84-3676132OtherWAMENTAL HEALTH
I20200129002235OtherWAMENTAL HEALTH

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20200129002235 WA Practitioner - Clinical Social Worker 1850727439 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mindful Therapy Group PCGroup PAC ID 4981872561, 654 clinicians

Practice addresses (Care Compare)

21907 64TH Ave W
Suite 200
Mountlake Terrace, WA 98043-6200
Phone (425) 640-7009

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LW60173119WAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Mindful Therapy Group PC Clinical CurrentSince Dec 31, 2019 Accepting new patients

Locations

6505 216th St SW
Ste 100
Mountlake Terrace, WA 98043
Phone (425) 678-6463

21907 64th Ave W
Ste 200
Mountlake Terrace, WA 98043
Phone (410) 258-3698

320 NE 97th St
Ste A
Seattle, WA 98115
Phone (206) 323-8113

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1491868800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1650499200000",
    "number": "1013440510",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 13306",
            "city": "MILL CREEK",
            "state": "WA",
            "postal_code": "980821306",
            "telephone_number": "425-686-8664"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21907 64TH AVE W STE 200",
            "city": "MOUNTLAKE TERRACE",
            "state": "WA",
            "postal_code": "980436200",
            "telephone_number": "425-640-7009"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "23210 9th Pl W",
            "address_purpose": "LOCATION",
            "city": "Bothell",
            "state": "WA",
            "postal_code": "980217310",
            "country_code": "US",
            "telephone_number": "206-406-9243",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CASWELL",
        "first_name": "PAULETTE",
        "middle_name": "M",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-04-11",
        "last_updated": "2022-04-21",
        "certification_date": "2021-02-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WA",
            "license": "LW60173119",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MENTAL HEALTH",
            "identifier": "84-3676132",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MENTAL HEALTH",
            "identifier": "I20200129002235",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mountlake Terrace, WA

Sources for this page

Verify at the official NPI Registry.