Melisa D Carson-Goldie, LW61506240

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

LW61506240 Issued in WA

Practice address

7100 Fort Dent Way Ste 220
Tukwila, WA 98188-8553

Phone

(206) 708-7274

NPI assigned

Apr 4, 2024

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

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Mindful Therapy Group PC

  • Clinical Social Worker
  • Mountlake Terrace, WA
  • NPI 1316238678
  Medicare reassignment NPD
• Tubman Center for Health & Freedom

  • School Nurse Practitioner
  • Seattle, WA
  • NPI 1265152169
  NPD (past)

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

{
    "created_epoch": "1712188800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719878400000",
    "number": "1346092095",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1504 S 207TH ST",
            "city": "SEATAC",
            "state": "WA",
            "postal_code": "981982611",
            "telephone_number": "530-519-3713"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7100 FORT DENT WAY STE 220",
            "city": "TUKWILA",
            "state": "WA",
            "postal_code": "981888553",
            "telephone_number": "206-708-7274"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARSON-GOLDIE",
        "first_name": "MELISA",
        "middle_name": "D",
        "credential": "LW61506240",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-04-04",
        "last_updated": "2024-07-02",
        "certification_date": "2024-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WA",
            "license": "SC60717516",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WA",
            "license": "LW61506240",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Valentina Carrero Bejarano
• Kathleen Ellen Carroll-Mahan, M. ED
• Kara Katherine Carroll
• Maureen Kay Carroll, MHP, AAC
• Erin Carruth, M.A., L.M.H.C.
• Brandon Christopher Carson
• Cheryl Teresa Carter, MS, LMHCA, CDPT
• Cascade Behavioral Hospital LLC
• Cascade Behavioral Hospital, LLC
• Austen Jill Case, MACP

• Clinical Social Worker in Tukwila, WA
• Providers in Tukwila, 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 Jul 2, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.