Mia Edidin

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

LW60161191 Issued in WA

Practice address

2319 N 45TH St
#303
Seattle, WA 98103-6982

Phone

(206) 659-7773

NPI assigned

Nov 20, 2012

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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 and National Provider Directory roles.

• Perinatal Support Washington

  • Clinical Social Worker
  • Seattle, WA
  • NPI 1528682440
  NPD Authorized official

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

{
    "created_epoch": "1353369600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706745600000",
    "number": "1093059628",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2319 N 45TH ST",
            "address_2": "#303",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981036982",
            "telephone_number": "206-659-7773"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2319 N 45TH ST",
            "address_2": "#303",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981036982",
            "telephone_number": "206-659-7773"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EDIDIN",
        "first_name": "MIA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-11-20",
        "last_updated": "2024-02-01",
        "certification_date": "2024-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WA",
            "license": "LW60161191",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Justin Michael Edge
• Justin Adam Edgerton, CDPT
• Nina Edgerton, LMP
• Michelle Edgett, ARNP
• Edgewood Seattle Addiction Services
• Janet Kay Edlefsen, M.S.
• Kerstin Lara Edlefsen, MD
• Stephanie Lynn Edler
• Edmc PLLC
• Sue Zee Edmison, ND LM

• Clinical Social Worker in Seattle, WA
• Providers in Seattle, WA by specialty
• Clinical Social Worker in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2024; 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.