Individual provider Active NPI

Timothy Smeekens, LCSW

  • Clinical Social Worker
  • Vancouver, WA
National Provider Identifier
1356586663
Registry record updated Dec 16, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
L3916 Issued in OR
Practice address
4405 NE 155TH Ave
Vancouver, WA 98682-7057
Phone
(503) 805-8059
NPI assigned
Dec 16, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 16, 2008

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X L3916 OR Primary
Clinical Social Worker 1041C0700X LW00009101 WA
Clinical Social Worker 1041C0700X 756 AK

Addresses

Primary practice location

4405 NE 155TH Ave
Vancouver, WA 98682-7057

Mailing address

4405 NE 155TH Ave
Vancouver, WA 98682-7057

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
756AKMDClinical Social Worker
L3916ORMDClinical Social Worker
LW00009101WAMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1229385600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1229385600000",
    "number": "1356586663",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4405 NE 155TH AVE",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986827057"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4405 NE 155TH AVE",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986827057",
            "telephone_number": "503-805-8059"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMEEKENS",
        "first_name": "TIMOTHY",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-12-16",
        "last_updated": "2008-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OR",
            "license": "L3916",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WA",
            "license": "LW00009101",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "AK",
            "license": "756",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vancouver, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2008; 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.