Willard Elbert Edmondson Jr., LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

LW00005212 Issued in WA

Practice address

613 19TH Ave E
Suite 102
Seattle, WA 98112-4075

Phone

(206) 322-5733

NPI assigned

Jan 27, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Mr. Eddie Edmondson Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/3511/brand/1/csg/1/fhir/r4

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

{
    "created_epoch": "1169856000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1294012800000",
    "number": "1033265376",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "613 19TH AVE E",
            "address_2": "SUITE 102",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981124075",
            "telephone_number": "206-322-5733"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "613 19TH AVE E",
            "address_2": "SUITE 102",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981124075",
            "telephone_number": "206-322-5733"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EDMONDSON",
        "first_name": "WILLARD",
        "middle_name": "ELBERT",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "LICSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-27",
        "last_updated": "2011-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WA",
            "license": "LW00005212",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "EDDIE",
            "last_name": "EDMONDSON",
            "prefix": "MR.",
            "credential": "LICSW",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Edmc PLLC
• Sue Zee Edmison, ND LM
• Albert W Edmonds, M.D.
• Annah Edmonds, LMHC
• Benjamin David Edmonds, MD
• Paul F Edmonson, M.D., PH.D.
• Christyn Marie Edmundson, MD
• Peter Joseph Montano Edpao, M.D.
• Sandra Edpao, FNP-C
• Vanessa Beth Edrich, 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 Jan 3, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.