Derrick M. Arciaga, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

LW60966243 Issued in WA

Practice address

4556 15TH Ave S
Seattle, WA 98108-1818

Phone

(206) 265-2935

NPI assigned

Nov 29, 2016

Sex

Male

Sole proprietor

No

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)

Not enrolled

State licenses

Practice roles

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.

• Recenter Self

  • Counselor
  • Issaquah, WA
  • NPI 1619595311
  NPD (past)

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

{
    "created_epoch": "1480377600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1593129600000",
    "number": "1124561865",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4556 15TH AVE S",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981081818",
            "telephone_number": "206-265-2935"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4556 15TH AVE S",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981081818",
            "telephone_number": "206-265-2935"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6020 35th Ave SW",
            "address_purpose": "LOCATION",
            "city": "Seattle",
            "state": "WA",
            "postal_code": "981263002",
            "country_code": "US",
            "telephone_number": "206-461-6950",
            "fax_number": "206-461-8542",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1200 12th Ave S",
            "address_purpose": "LOCATION",
            "city": "Seattle",
            "state": "WA",
            "postal_code": "981442712",
            "country_code": "US",
            "telephone_number": "206-326-2400",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ARCIAGA",
        "first_name": "DERRICK",
        "middle_name": "M.",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-11-29",
        "last_updated": "2020-06-26",
        "certification_date": "2020-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "WA",
            "license": "LW60966243",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WA",
            "license": "LW60966243",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Trefan Archibald, MD
• Lisa Sumiko Archide, OTR/L
• Elizabeth Archuleta
• Zachary Archuleta
• Archways - Aphasia Rehabilitation Services PLLC
• Paula Arciaga, D.O.
• Arctic Pain Partners Incorporated
• Maribel Arcuino, EAMP
• Stephanie Ardakani
• Alice Arden, C-FSD

• All providers in Seattle, WA
• Clinical Social Worker in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2020; 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.