Charles Owen Bartlett IV, MSW LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

603077273 Issued in WA

Practice address

16000 Bothell Everett Hwy
360
Mill Creek, WA 98012-1742

Phone

(425) 357-9111

NPI assigned

Feb 2, 2011

Last updated

Feb 2, 2011By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Nov 17, 2017 through Nov 17, 2027

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Mill Creek Family Services, PLLC

  • Mental Health Counselor
  • Mill Creek, WA
  • NPI 1902241623
  NPD (past)

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

{
    "created_epoch": "1296604800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1296604800000",
    "number": "1194021550",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2530 NE 203RD ST",
            "city": "SHORELINE",
            "state": "WA",
            "postal_code": "981551422",
            "telephone_number": "206-300-3889"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16000 BOTHELL EVERETT HWY",
            "address_2": "360",
            "city": "MILL CREEK",
            "state": "WA",
            "postal_code": "980121742",
            "telephone_number": "425-357-9111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BARTLETT",
        "first_name": "CHARLES",
        "middle_name": "OWEN",
        "name_prefix": "Mr.",
        "name_suffix": "IV",
        "credential": "MSW LICSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-02-02",
        "last_updated": "2011-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WA",
            "license": "603077273",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Andrew Claire Baker, LMFT
• Mariel Liane Balboa, DO
• Michael Rowland Balcombe
• Erin Baldwin, D.C.
• Lauren Maurissa Baras, M.D.
• Katrina Bassett, M.D.
• Neal Eden Bastian, DDS MSD
• Brianna Joan Baublitz, DNP, ARNP
• Craig Leigh Baugher, PA
• Nancy D Bennett, LMHC CDP

• Clinical Social Worker in Mill Creek, WA
• Providers in Mill Creek, 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 Feb 2, 2011; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.