Amy Ebersole, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

LW61075196 Issued in WA

Practice address

2427 Lincoln St
Bellingham, WA 98225-3841

Phone

(360) 220-9240

NPI assigned

Apr 22, 2016

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

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.

• Lake Whatcom Residential & Treatment Center

  • Community/Behavioral Health Agency
  • Bellingham, WA
  • NPI 1043281736
  NPD (past)
• Lake Whatcom Residential & Treatment Center

  • Case Management Agency
  • Bellingham, WA
  • NPI 1780991844
  NPD (past)

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

{
    "created_epoch": "1461283200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607558400000",
    "number": "1184078495",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2950 NEWMARKET ST STE 101342",
            "city": "BELLINGHAM",
            "state": "WA",
            "postal_code": "982263872",
            "telephone_number": "360-220-9240"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2427 LINCOLN ST",
            "city": "BELLINGHAM",
            "state": "WA",
            "postal_code": "982253841",
            "telephone_number": "360-220-9240"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3645 E McLeod Rd",
            "address_purpose": "LOCATION",
            "city": "Bellingham",
            "state": "WA",
            "postal_code": "982268700",
            "country_code": "US",
            "telephone_number": "360-922-6681",
            "fax_number": "360-676-7750",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "EBERSOLE",
        "first_name": "AMY",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-04-22",
        "last_updated": "2020-12-10",
        "certification_date": "2020-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WA",
            "license": "LW61075196",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "elementstw@protonmail.com",
            "affiliation": "N",
            "endpointDescription": "business email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "2950 Newmarket St Ste 101342",
            "city": "Bellingham",
            "state": "WA",
            "country_code": "US",
            "postal_code": "982263872",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Kara Eads, LMHC
• Sandra H Earle, MD
• Lindy Early-Rosen, L.M.P.
• Kenneth Eastham
• Melody Anne Eastman
• Laurel Eby
• E'Lana A. Ecker, SLP
• Eco-Healing, LLC
• Eden Hospice at Whatcom County, LLC
• Jerome Edge, CPC

• Clinical Social Worker in Bellingham, WA
• Providers in Bellingham, 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 Dec 10, 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.