Active NPI
Kaylene Goldgrabe Hartt, LCSW
- Clinical Social Worker
- Fairchild Afb, WA
National Provider Identifier
1295339976
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- LCSW-38589
- Practice address
- 701 Hospital Loop
Fairchild Afb, WA 99011-8704 - Phone
- (509) 247-2731
- NPI assigned
- Nov 24, 2020
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | LCSW-38589 | ID | Primary |
Addresses
Primary practice location
701 Hospital Loop
Fairchild Afb, WA 99011-8704
Mailing address
701 Hospital Loop
Fairchild Afb, WA 99011-8704
Phone (509) 247-2731
Other names 1
- Kaylene Elizabeth Goldgrabe
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
| License | State | Type | Specialty |
|---|---|---|---|
| LCSW-38589 | ID | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1606176000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1737590400000",
"number": "1295339976",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "701 HOSPITAL LOOP",
"city": "FAIRCHILD AFB",
"state": "WA",
"postal_code": "990118704",
"telephone_number": "509-247-2731"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "701 HOSPITAL LOOP",
"city": "FAIRCHILD AFB",
"state": "WA",
"postal_code": "990118704",
"telephone_number": "509-247-2731"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HARTT",
"first_name": "KAYLENE",
"middle_name": "GOLDGRABE",
"name_prefix": "Mrs.",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-11-24",
"last_updated": "2025-01-23",
"certification_date": "2025-01-23",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "ID",
"license": "LCSW-38589",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "KAYLENE",
"last_name": "GOLDGRABE",
"middle_name": "ELIZABETH",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Fairchild Afb, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.