Sarah Self Gautreaux, MSW, LICSWA

Primary specialty

Social WorkerTaxonomy code 104100000X

Practice address

612 Woodland Square Loop SE Ste 401
Lacey, WA 98503

Phone

(360) 754-1338

NPI assigned

Jul 21, 2014

Last updated

Aug 7, 2019By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Scott Robert Self Former name

Medicare fee-for-service enrollment

Enrolled in WA, OH2 enrollments

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 2

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Emily Program PC

  dba The Emily Program

  • Community/Behavioral Health Agency
  • Seattle, WA
  • NPI 1154696698
  Medicare reassignment NPD
• Emily Program P C

  dba The Emily Program

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Saint Paul, MN
  • NPI 1528165065

  OH

  Medicare reassignment NPD

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

{
    "created_epoch": "1405900800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1565136000000",
    "number": "1063829125",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2922 RUDDELL RD SE APT 29",
            "city": "LACEY",
            "state": "WA",
            "postal_code": "985037810",
            "telephone_number": "337-315-1430"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "612 WOODLAND SQUARE LOOP SE STE 401",
            "city": "LACEY",
            "state": "WA",
            "postal_code": "98503",
            "telephone_number": "360-754-1338"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "908 5th Ave SE",
            "address_purpose": "LOCATION",
            "city": "Olympia",
            "state": "WA",
            "postal_code": "985011507",
            "country_code": "US",
            "telephone_number": "360-754-2423",
            "fax_number": "360-357-2819",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GAUTREAUX",
        "first_name": "SARAH",
        "middle_name": "SELF",
        "credential": "MSW, LICSWA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-07-21",
        "last_updated": "2019-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SCOTT",
            "last_name": "SELF",
            "middle_name": "ROBERT",
            "credential": "MSW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Marquelle Renee Garibay, LMT
• Ashley Rashell Garrard
• Katie Nicole Gaskins, LICSW
• Samuel Wairegi Gathura
• Bryan Keith Gauck, LPN
• April Rose Gaydos, LMP
• Ellen Geary, MS
• Douglas Gemmell
• Generations Midwifery Services, LLC
• Geneva Woods Health Supplies PNW, LLC (MyMedSupplies)

• Social Worker in Lacey, WA
• Providers in Lacey, WA by specialty
• Social Worker in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.