Individual provider Active NPI

R. D. Suz Foretich, LICSW

  • Clinical Social Worker
  • Seattle, WA
National Provider Identifier
1114390010
Registry record updated Jun 27, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LW60907426 Issued in WA
Practice address
2366 Eastlake Ave E Ste 320
Seattle, WA 98102-3399
Phone
(206) 790-1843
NPI assigned
Nov 2, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 27, 2019

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 SC60584558 WA
Clinical Social Worker 1041C0700X LW60907426 WA Primary

Addresses

Primary practice location

2366 Eastlake Ave E Ste 320
Seattle, WA 98102-3399

Mailing address

2366 Eastlake Ave E Ste 320
Seattle, WA 98102-3399
Phone (206) 790-1843

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
LW60907426WAMDClinical Social Worker
SC60584558WAMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1446422400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1561593600000",
    "number": "1114390010",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2366 EASTLAKE AVE E STE 320",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981023399",
            "telephone_number": "206-790-1843"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2366 EASTLAKE AVE E STE 320",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981023399",
            "telephone_number": "206-790-1843"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FORETICH",
        "first_name": "R. D.",
        "middle_name": "SUZ",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-11-02",
        "last_updated": "2019-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WA",
            "license": "SC60584558",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WA",
            "license": "LW60907426",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Seattle, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2019; 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.