Pamela Phyllis Lavergne, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

LW60838119 Issued in WA

Practice address

2905A Hewitt Ave
Everett, WA 98201-3821

Phone

(425) 626-1620

NPI assigned

Nov 12, 2009

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1257984000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681430400000",
    "number": "1205163193",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2905A HEWITT AVE",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982013821",
            "telephone_number": "425-626-1620"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2905A HEWITT AVE",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982013821",
            "telephone_number": "425-626-1620"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2722 Colby Ave",
            "address_2": "Suite 610",
            "address_purpose": "LOCATION",
            "city": "Everett",
            "state": "WA",
            "postal_code": "982013557",
            "country_code": "US",
            "telephone_number": "425-257-1621",
            "fax_number": "425-257-1767",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LAVERGNE",
        "first_name": "PAMELA",
        "middle_name": "PHYLLIS",
        "credential": "LICSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-11-12",
        "last_updated": "2023-04-14",
        "certification_date": "2023-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WA",
            "license": "LW60838119",
            "primary": true
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WA",
            "license": "RC00054513",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elizabeth Anne Lauer Reed
• Stacey Laughlin
• Kristina Laurente, PHARMD
• Ashley Laures
• Kimmie Taylor Laureta
• Sondra Lee Laverne, L.M.H.C.
• Danielle Lavilla, OTR/L
• Milan Law
• Nathan Lawless, RPH
• Austen Lawrence, DO

• Clinical Social Worker in Everett, WA
• Providers in Everett, 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 Apr 14, 2023; 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.