Individual provider Active NPI

Mikala Davis, LCSW

  • Clinical Social Worker
  • Bellingham, WA
National Provider Identifier
1356195994
Registry record updated Apr 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LW61336977 Issued in WA
Practice address
2592 Kwina Rd
Bellingham, WA 98226-9278
Phone
(360) 384-0464
NPI assigned
Apr 11, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 11, 2024

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 LW61336977 WA Primary

Addresses

Primary practice location

2592 Kwina Rd
Bellingham, WA 98226-9278

Mailing address

2592 Kwina Rd
Bellingham, WA 98226-9278
Phone (360) 384-0464

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
I20240827000473 TX Practitioner - Clinical Social Worker 3577002203 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lummi Indian Business CouncilGroup PAC ID 5395738231, 26 clinicians

Practice addresses (Care Compare)

2665 Kwina Rd
Bellingham, WA 98226-9291
Phone (360) 312-2489

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LW61336977WAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Lummi Indian Business Council CurrentSince Jun 6, 2024 Accepting new patients
Lummi Indian Business Council CurrentSince Jun 6, 2024 Accepting new patients

Locations

2665 Kwina Rd
Bellingham, WA 98226
Phone (360) 312-2019

2592 Kwina Rd
Bellingham, WA 98226
Phone (360) 312-2000

Organizations & group practices 2

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": "1712793600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712793600000",
    "number": "1356195994",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2592 KWINA RD",
            "city": "BELLINGHAM",
            "state": "WA",
            "postal_code": "982269278",
            "telephone_number": "360-384-0464"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2592 KWINA RD",
            "city": "BELLINGHAM",
            "state": "WA",
            "postal_code": "982269278",
            "telephone_number": "360-384-0464"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "MIKALA",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-04-11",
        "last_updated": "2024-04-11",
        "certification_date": "2024-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WA",
            "license": "LW61336977",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bellingham, WA

Sources for this page

Verify at the official NPI Registry.