Individual provider Active NPI

Joseph D Endres, MSP, MSW, LICSWA

  • Clinical Social Worker
  • Spokane, WA
National Provider Identifier
1063933026
Registry record updated Aug 31, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
SC61425310 Issued in WA
Practice address
100 N Howard St Ste W
Spokane, WA 99201-0508
Phone
(509) 720-7282
NPI assigned
Jun 29, 2017
Last updated
Aug 31, 2023By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 31, 2023

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 SC61425310 WA Primary

Addresses

Primary practice location

100 N Howard St Ste W
Spokane, WA 99201-0508

Mailing address

903 Pheasant Rd
Centralia, WA 98531-1547
Phone (360) 521-9341

Other identifiers 1

IdentifierTypeStateIssuer
122994MedicaidOR

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

LicenseStateTypeSpecialty
SC61425310WAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Marion County PastSince Jul 1, 2022 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1498694400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693440000000",
    "number": "1063933026",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "903 PHEASANT RD",
            "city": "CENTRALIA",
            "state": "WA",
            "postal_code": "985311547",
            "telephone_number": "360-521-9341"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 N HOWARD ST STE W",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992010508",
            "telephone_number": "509-720-7282"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ENDRES",
        "first_name": "JOSEPH",
        "middle_name": "D",
        "name_prefix": "Mr.",
        "credential": "MSP, MSW, LICSWA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-06-29",
        "last_updated": "2023-08-31",
        "certification_date": "2023-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WA",
            "license": "SC61425310",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "122994",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Spokane, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2023; 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.