Individual provider Active NPI

Abraham J Pena, LMP, MSW, LICSW

  • Clinical Social Worker
  • Seattle, WA
National Provider Identifier
1245619402
Registry record updated Nov 5, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LW60814904 Issued in WA
Practice address
3715 S Hudson St Ste 102
Seattle, WA 98118-2171
Phone
(206) 457-2839
NPI assigned
May 21, 2015
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 5, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Massage Therapist 225700000X MA 60529305 WA
Clinical Social Worker 1041C0700X LW60814904 WA Primary

Addresses

Primary practice location

3715 S Hudson St Ste 102
Seattle, WA 98118-2171

Mailing address

3715 S Hudson St Ste 102
Seattle, WA 98118-2171
Phone (206) 745-2063

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
I20200227000654 WA Practitioner - Clinical Social Worker 0345677571 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

5425 Rainier Ave S
Suite a
Seattle, WA 98118-2455
Phone (206) 457-2839

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LW60814904WAMDClinical Social Worker
MA 60529305WAMDMassage Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Abraham Pena Psychotherapy PLLC Clinical CurrentSince Sep 1, 2020 Accepting new patients

Locations

5425 Rainier Ave S
Ste A
Seattle, WA 98118
Phone (206) 245-3756

3715 S Hudson St
Ste 102
Seattle, WA 98118
Phone (206) 408-6534

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": "1432166400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1762300800000",
    "number": "1245619402",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3715 S HUDSON ST STE 102",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981182171",
            "telephone_number": "206-745-2063"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3715 S HUDSON ST STE 102",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981182171",
            "telephone_number": "206-457-2839"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PENA",
        "first_name": "ABRAHAM",
        "middle_name": "J",
        "name_prefix": "Mr.",
        "credential": "LMP, MSW, LICSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-05-21",
        "last_updated": "2025-11-05",
        "certification_date": "2025-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "WA",
            "license": "MA 60529305",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WA",
            "license": "LW60814904",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Seattle, WA

Sources for this page

Verify at the official NPI Registry.