Active NPI
John Simpkin, LICSW
- Clinical Social Worker
- Richland, WA
National Provider Identifier
1174676258
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- LW00006337
- Practice address
- 719 Jadwin Ave Ofc 17
Richland, WA 99352-4217 - Phone
- (509) 396-1777
- Fax
- (509) 210-8105
- NPI assigned
- Jan 19, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | LW00006337 | WA | Primary |
Addresses
Primary practice location
719 Jadwin Ave Ofc 17
Richland, WA 99352-4217
Mailing address
719 Jadwin Ave Ofc 17
Richland, WA 99352-4217
Phone (509) 396-1777
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2033678 | Medicaid | WA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LW00006337 | WA | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| The Emmaus Center | Mental Health | Current | Accepting new patients |
| Sunderland Family Treatment Services | Past | Accepting new patients |
Locations
1124 Stevens Dr
Richland, WA 99354
Phone (509) 876-4009
Organizations & group practices 2
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.
-
- Clinic/Center
- Kennewick, WA
- NPI 1255389698
-
- Mental Health Counselor
- Richland, WA
- NPI 1891898953
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1169164800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1720051200000",
"number": "1174676258",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "719 JADWIN AVE OFC 17",
"city": "RICHLAND",
"state": "WA",
"postal_code": "993524217",
"telephone_number": "509-396-1777",
"fax_number": "509-210-8105"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "719 JADWIN AVE OFC 17",
"city": "RICHLAND",
"state": "WA",
"postal_code": "993524217",
"telephone_number": "509-396-1777",
"fax_number": "509-210-8105"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SIMPKIN",
"first_name": "JOHN",
"name_prefix": "Mr.",
"credential": "LICSW",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-01-19",
"last_updated": "2024-07-04",
"certification_date": "2024-07-04",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "WA",
"license": "LW00006337",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "2033678",
"state": "WA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Richland, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 4, 2024; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.