Individual provider Active NPI

John Simpkin, LICSW

  • Clinical Social Worker
  • Richland, WA
National Provider Identifier
1174676258
Registry record updated Jul 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LW00006337 Issued in WA
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

Updated by the provider on Jul 4, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
2033678MedicaidWA

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
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LW00006337WAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
The Emmaus Center Mental Health CurrentSince Jun 1, 2022 Accepting new patients
Sunderland Family Treatment Services PastSince Sep 20, 2005 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.

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

Verify at the official NPI Registry.