Individual provider Active NPI

Carly Hensley, MSW, LICSW, MHP

  • Clinical Social Worker
  • Longview, WA
National Provider Identifier
1184249849
Registry record updated Mar 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LW61436950 Issued in WA
Practice address
748 14TH Ave
Longview, WA 98632-2315
Phone
(360) 200-5419
Fax
(360) 200-6736
NPI assigned
Jun 9, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 25, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X LW61436950 WA
Clinical Social Worker 1041C0700X LW61436950 WA Primary

Addresses

Primary practice location

748 14TH Ave
Longview, WA 98632-2315

Mailing address

PO Box 2394
Longview, WA 98632
Phone (360) 200-5419

Other identifiers 1

IdentifierTypeStateIssuer
2159190MedicaidWA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
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 1

Enrollment IDStateProvider typePAC IDDetails
I20250418001636 WA Practitioner - Clinical Social Worker 9931624210 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Core HealthGroup PAC ID 0941631469, 8 clinicians

Practice addresses (Care Compare)

748 14TH Ave
Longview, WA 98632-2315
Phone (360) 200-5419

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LW61436950WAMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Core Health CurrentSince Apr 10, 2025 Accepting new patients

Locations

1126 S Gold St
Centralia, WA 98531
Phone (360) 807-4929

748 14th Ave
Longview, WA 98632
Phone (360) 200-5419

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1591660800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742860800000",
    "number": "1184249849",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2394",
            "city": "LONGVIEW",
            "state": "WA",
            "postal_code": "98632",
            "telephone_number": "360-200-5419",
            "fax_number": "360-200-6736"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "748 14TH AVE",
            "city": "LONGVIEW",
            "state": "WA",
            "postal_code": "986322315",
            "telephone_number": "360-200-5419",
            "fax_number": "360-200-6736"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENSLEY",
        "first_name": "CARLY",
        "credential": "MSW, LICSW, MHP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-06-09",
        "last_updated": "2025-03-25",
        "certification_date": "2025-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "WA",
            "license": "LW61436950",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WA",
            "license": "LW61436950",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2159190",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Longview, WA

Sources for this page

Verify at the official NPI Registry.