Individual provider Active NPI

Emily Last, LICSW

  • Mental Health Counselor
  • Port Angeles, WA
National Provider Identifier
1114048873
Registry record updated Dec 15, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
LW60524212 Issued in WA
Practice address
513 E 8TH St
Port Angeles, WA 98362-6221
Phone
(360) 477-5668
NPI assigned
Apr 2, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 15, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X LW60524212 WA
Mental Health Counselor 101YM0800X LW60524212 WA Primary

Addresses

Primary practice location

513 E 8TH St
Port Angeles, WA 98362-6221

Mailing address

513 E 8TH St
Port Angeles, WA 98362-6221
Phone (360) 477-5668

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
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 1

Enrollment IDStateProvider typePAC IDDetails
I20150225002478 WA Practitioner - Clinical Social Worker 8729135199 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

513 E 8TH St
Port Angeles, WA 98362-6221
Phone (360) 477-5668

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LW60524212WAMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Emily Landis Licsw PLLC CurrentSince Oct 1, 2017 Accepting new patients

Locations

513 E 8th St
Port Angeles, WA 98362
Phone (360) 460-4071

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": "1175472000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702598400000",
    "number": "1114048873",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "513 E 8TH ST",
            "city": "PORT ANGELES",
            "state": "WA",
            "postal_code": "983626221",
            "telephone_number": "360-477-5668"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "513 E 8TH ST",
            "city": "PORT ANGELES",
            "state": "WA",
            "postal_code": "983626221",
            "telephone_number": "360-477-5668"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAST",
        "first_name": "EMILY",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-02",
        "last_updated": "2023-12-15",
        "certification_date": "2023-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WA",
            "license": "LW60524212",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WA",
            "license": "LW60524212",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Angeles, WA

Sources for this page

Verify at the official NPI Registry.