Active NPI
Sharon Lynn Dougan, MSW
- Clinical Social Worker
- Bothell, WA
National Provider Identifier
1053563775
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- LW00006256
- Practice address
- 23217 39TH Ave SE
Bothell, WA 98021-9002 - Phone
- (425) 485-2158
- NPI assigned
- Oct 13, 2008
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | LW00006256 | WA | Primary |
Addresses
Primary practice location
23217 39TH Ave SE
Bothell, WA 98021-9002
Mailing address
PO Box 2262
Bothell, WA 98041-2262
Phone (425) 485-2158
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 |
|---|---|---|---|
| LW00006256 | WA | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Re-Source Counseling Center, PLLC | Clinical | Past | Accepting new patients |
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": "1223856000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1223856000000",
"number": "1053563775",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 2262",
"city": "BOTHELL",
"state": "WA",
"postal_code": "980412262",
"telephone_number": "425-485-2158"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "23217 39TH AVE SE",
"city": "BOTHELL",
"state": "WA",
"postal_code": "980219002",
"telephone_number": "425-485-2158"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DOUGAN",
"first_name": "SHARON",
"middle_name": "LYNN",
"credential": "MSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-10-13",
"last_updated": "2008-10-13",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "WA",
"license": "LW00006256",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bothell, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.