Individual provider Active NPI

Stephanie Perrine, LICSW

  • Clinical Social Worker
  • Tacoma, WA
National Provider Identifier
1073174629
Registry record updated Nov 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LW61472121 Issued in WA
Practice address
9040 Jackson Ave
Tacoma, WA 98431-6033
Phone
(360) 320-6544
NPI assigned
Jun 25, 2019
Last updated
Nov 14, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 14, 2025

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 LW61472121 WA Primary

Addresses

Primary practice location

9040 Jackson Ave
Tacoma, WA 98431-6033

Mailing address

9040 Jackson Ave Tacoma Wa
Tacoma, WA 98431-0001
Phone (253) 968-2252

Other practice location 1

1155 SE City Beach St Unit 2033
Oak Harbor, WA 98277-2987
Phone (360) 320-6544

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
LW61472121WAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Stillwater Behavioral Health and Wellness, PLLC Clinical CurrentSince Nov 18, 2025 Accepting new patients

Locations

1155 SE City Beach St
Unit 2033
Oak Harbor, WA 98277
Phone (360) 320-6544

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": "1561420800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1763078400000",
    "number": "1073174629",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9040 JACKSON AVE TACOMA WA",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984310001",
            "telephone_number": "253-968-2252"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9040 JACKSON AVE",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984316033",
            "telephone_number": "360-320-6544"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1155 SE City Beach St Unit 2033",
            "address_purpose": "LOCATION",
            "city": "Oak Harbor",
            "state": "WA",
            "postal_code": "982772987",
            "country_code": "US",
            "telephone_number": "360-320-6544",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PERRINE",
        "first_name": "STEPHANIE",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-06-25",
        "last_updated": "2025-11-14",
        "certification_date": "2025-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WA",
            "license": "LW61472121",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tacoma, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2025; 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.