Douglas Mark Whalen, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

LW61657034 Issued in WA

Practice address

22620 SE 4TH St Ste 130
Sammamish, WA 98074-7375

Phone

(855) 402-1364

Fax

(425) 974-7861

NPI assigned

Jun 2, 2021

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Specialty

Clinical Social Worker

Education

Other, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Western Psychological and Counseling Services LLCGroup PAC ID 7719975085, 331 clinicians

Practice addresses (Care Compare)

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.

• Western Psychological and Counseling Services LLC

  dba LifeStance Health

  • Clinical Psychologist
  • Vancouver, WA
  • NPI 1629345731

  Counselor

  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1622592000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1751932800000",
    "number": "1114593886",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22620 SE 4TH ST STE 130",
            "city": "SAMMAMISH",
            "state": "WA",
            "postal_code": "980747375",
            "telephone_number": "855-402-1364",
            "fax_number": "425-974-7861"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22620 SE 4TH ST STE 130",
            "city": "SAMMAMISH",
            "state": "WA",
            "postal_code": "980747375",
            "telephone_number": "855-402-1364",
            "fax_number": "425-974-7861"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHALEN",
        "first_name": "DOUGLAS",
        "middle_name": "MARK",
        "name_prefix": "Mr.",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-06-02",
        "last_updated": "2025-07-08",
        "certification_date": "2025-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WA",
            "license": "LW61657034",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2178499",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Washington Dental Corporation, PC (Sammamish Smiles Dentistry)
• Jessica Signe Wattnem, MA, LMFTA
• Ann Weber, PT
• Jennifer Weber, IBCLC, RN
• Cheng Yang Wen, D.C.
• Katherine Elisa Williams, MD
• Madeleine Williams, ARNP
• Roberta Winch, MD
• Allison Witham, MA
• Stephani Wolfe, LICSW

• Clinical Social Worker in Sammamish, WA
• Providers in Sammamish, 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 Jul 8, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.