Individual provider Active NPI

Kari Ann Knutson-Bradac, MSW, LICSW

  • Clinical Social Worker
  • Olympia, WA
National Provider Identifier
1184664195
Registry record updated Jan 10, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LW00004132 Issued in WA
Practice address
3221 French LN NW
Olympia, WA 98502-3972
Phone
(360) 481-5981
Fax
(360) 867-0772
NPI assigned
Jun 7, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 10, 2008

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 LW00004132 WA Primary

Addresses

Primary practice location

3221 French LN NW
Olympia, WA 98502-3972

Mailing address

3221 French LN NW
Olympia, WA 98502-3972
Phone (360) 481-5981

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LW00004132WAMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1149638400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1199923200000",
    "number": "1184664195",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3221 FRENCH LN NW",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "985023972",
            "telephone_number": "360-481-5981",
            "fax_number": "360-867-0772"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3221 FRENCH LN NW",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "985023972",
            "telephone_number": "360-481-5981",
            "fax_number": "360-867-0772"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KNUTSON-BRADAC",
        "first_name": "KARI",
        "middle_name": "ANN",
        "name_prefix": "Ms.",
        "credential": "MSW, LICSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-06-07",
        "last_updated": "2008-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WA",
            "license": "LW00004132",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Olympia, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2008; 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.