Individual provider Active NPI

Marlencia Jean Williams, LICSW

  • Clinical Social Worker
  • Tukwila, WA
National Provider Identifier
1215687934
Registry record updated Jun 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LW61599046 Issued in WA
Practice address
15455 65TH Ave S
Tukwila, WA 98188-2534
Phone
(206) 721-5170
Fax
(360) 353-9440
NPI assigned
Mar 25, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 18, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X SC61213994 WA
Social Worker 104100000X SC61213994 WA
Clinical Social Worker 1041C0700X LW61599046 WA Primary

Addresses

Primary practice location

15455 65TH Ave S
Tukwila, WA 98188-2534

Mailing address

PO Box 2429
Longview, WA 98632-8486
Phone (360) 353-9494

Other practice location 1

419 S 2nd St Ste 2
Renton, WA 98057-2234
Phone (206) 305-5581

Other names 1

  • Marlencia Williams Professional name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20250714002441 TX Practitioner - Clinical Social Worker 5597270140 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
SC61213994WAMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Cowlitz Indian Tribe CurrentSince Jun 16, 2025 Accepting new patients
Cowlitz Indian Tribe CurrentSince Jun 16, 2025 Accepting new patients
Cowlitz Indian Tribe Past Accepting new patients
Cowlitz Indian Tribe Past Accepting new patients
Cowlitz Indian Tribe Past Accepting new patients
Cowlitz Indian Tribe Past Accepting new patients
Cowlitz Indian Tribe Past Accepting new patients

Locations

15455 65th Ave S
Tukwila, WA 98188
Phone (206) 721-5170

Organizations & group practices 7

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.

NPI Registry JSON

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

{
    "created_epoch": "1648166400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750204800000",
    "number": "1215687934",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2429",
            "city": "LONGVIEW",
            "state": "WA",
            "postal_code": "986328486",
            "telephone_number": "360-353-9494",
            "fax_number": "360-353-9440"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15455 65TH AVE S",
            "city": "TUKWILA",
            "state": "WA",
            "postal_code": "981882534",
            "telephone_number": "206-721-5170",
            "fax_number": "360-353-9440"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "419 S 2nd St Ste 2",
            "address_purpose": "LOCATION",
            "city": "Renton",
            "state": "WA",
            "postal_code": "980572234",
            "country_code": "US",
            "telephone_number": "206-305-5581",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "MARLENCIA",
        "middle_name": "JEAN",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-03-25",
        "last_updated": "2025-06-18",
        "certification_date": "2025-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "WA",
            "license": "SC61213994",
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "WA",
            "license": "SC61213994",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WA",
            "license": "LW61599046",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARLENCIA",
            "last_name": "WILLIAMS",
            "credential": "LICSW",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Tukwila, WA

Sources for this page

Verify at the official NPI Registry.