Individual provider Active NPI

Penny Hougland, L.I.C.S.W.

  • Clinical Social Worker
  • Bellingham, WA
National Provider Identifier
1043423031
Registry record updated Sep 9, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
885011106 Issued in WV
Practice address
909 Harris Ave
Ste 201H
Bellingham, WA 98225-7080
Phone
(360) 758-4234
Fax
(360) 758-4234
NPI assigned
May 7, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 9, 2016

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 885011106 WV Primary

Addresses

Primary practice location

909 Harris Ave
Ste 201H
Bellingham, WA 98225-7080

Mailing address

909 Harris Ave
Ste 201H
Bellingham, WA 98225-7080
Phone (360) 758-4234

Other identifiers 1

IdentifierTypeStateIssuer
001718108OtherWVMOUNTAIN STATE BLUE CROSS

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
I20141017000396 WA Practitioner - Clinical Social Worker 3678794559 Practice locations: Bellingham, WA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

119 N Commercial St
Suite 1504
Bellingham, WA 98225-4492
Phone (360) 758-4234

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
885011106WVMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1178496000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1473379200000",
    "number": "1043423031",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "909 HARRIS AVE",
            "address_2": "STE 201H",
            "city": "BELLINGHAM",
            "state": "WA",
            "postal_code": "982257080",
            "telephone_number": "360-758-4234",
            "fax_number": "360-758-4234"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "909 HARRIS AVE",
            "address_2": "STE 201H",
            "city": "BELLINGHAM",
            "state": "WA",
            "postal_code": "982257080",
            "telephone_number": "360-758-4234",
            "fax_number": "360-758-4234"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOUGLAND",
        "first_name": "PENNY",
        "credential": "L.I.C.S.W.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-07",
        "last_updated": "2016-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WV",
            "license": "885011106",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MOUNTAIN STATE BLUE CROSS",
            "identifier": "001718108",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bellingham, WA

Sources for this page

Verify at the official NPI Registry.