Vivian Tejera, LICSW, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

LW61670578 Issued in WA

Practice address

12025 115TH Ave NE Ste 200
Kirkland, WA 98034-6935

Phone

(425) 821-1810

NPI assigned

May 1, 2014

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 5

Addresses

Other names 1

• Vivian Lacy Former name

Medicare fee-for-service enrollment

Enrolled in FL, WA2 enrollments

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 2

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.

• Ace Behavioral Health LLC

  • Psychiatry Physician
  • Tampa, FL
  • NPI 1841094885
  Medicare reassignment NPD
• MCR Health, Inc.

  • Federally Qualified Health Center (FQHC)
  • Parrish, FL
  • NPI 1255376000
  Medicare reassignment NPD
• Optum Behavioral Care of Colorado, P.C.

  • Clinical Psychologist
  • Seattle, WA
  • NPI 1114797545
  NPD
• MCR Health, Inc.

  dba Riverside Medical Center

  • Non-Pharmacy Dispensing Site
  • Bradenton, FL
  • NPI 1821878745
  NPD
• Optum Behavioral Care of Colorado, P.C.

  • Clinical Social Worker
  • De Pere, WI
  • NPI 1396622494
  NPD

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

{
    "created_epoch": "1398902400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1773878400000",
    "number": "1184034050",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12025 115TH AVE NE STE 200",
            "city": "KIRKLAND",
            "state": "WA",
            "postal_code": "980346935"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12025 115TH AVE NE STE 200",
            "city": "KIRKLAND",
            "state": "WA",
            "postal_code": "980346935",
            "telephone_number": "425-821-1810"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TEJERA",
        "first_name": "VIVIAN",
        "name_prefix": "Mrs.",
        "credential": "LICSW, LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-05-01",
        "last_updated": "2026-03-19",
        "certification_date": "2026-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WA",
            "license": "LW61670578",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW20424",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OR",
            "license": "L17141",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "C018302",
            "primary": false
        },
        {
            "code": "222Q00000X",
            "taxonomy_group": "",
            "desc": "Developmental Therapist",
            "state": "FL",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "VIVIAN",
            "last_name": "LACY",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Eric William Taylor, MD
• Erin Taylor
• Grace Taylor
• Richard Michael Taylor, LPN
• Colleen Tee
• Telehealth Medical Group
• Telehealth MH LLC
• Senait Besrat Tensae, RN
• Teresa K Kang DDS
• Teresa K Yagi DDS PLLC

• Clinical Social Worker in Kirkland, WA
• Providers in Kirkland, 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 Mar 19, 2026; 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.

Verify at the official NPI Registry.