Individual provider Active NPI

Kerri Ann Duke

  • Clinical Social Worker
  • Olympia, WA
National Provider Identifier
1255952628
Registry record updated Apr 27, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LW00007584 Issued in WA
Practice address
6706 Prairie Ridge Dr NE
Olympia, WA 98516-6248
Phone
(360) 455-0202
Fax
(360) 455-0202
NPI assigned
Apr 27, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 27, 2020

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 LW00007584 WA Primary

Addresses

Primary practice location

6706 Prairie Ridge Dr NE
Olympia, WA 98516-6248

Mailing address

6706 Prairie Ridge Dr NE
Olympia, WA 98516-6248
Phone (360) 455-0202

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
LW00007584WAMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1587945600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1587945600000",
    "number": "1255952628",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6706 PRAIRIE RIDGE DR NE",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "985166248",
            "telephone_number": "360-455-0202"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6706 PRAIRIE RIDGE DR NE",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "985166248",
            "telephone_number": "360-455-0202",
            "fax_number": "360-455-0202"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUKE",
        "first_name": "KERRI",
        "middle_name": "ANN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-04-27",
        "last_updated": "2020-04-27",
        "certification_date": "2020-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WA",
            "license": "LW00007584",
            "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 Apr 27, 2020; 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.