Active NPI
Simon B. Paquette, LCSW
- Clinical Social Worker
- Vancouver, WA
National Provider Identifier
1376530584
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 2650
- Practice address
- 18608 SE 36TH Cir
Vancouver, WA 98683-8244 - Phone
- (360) 903-4385
- Fax
- (360) 449-0009
- NPI assigned
- Oct 3, 2005
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 2650 | OR | Primary |
| Clinical Social Worker | 1041C0700X | LW 60041917 | WA |
Addresses
Primary practice location
18608 SE 36TH Cir
Vancouver, WA 98683-8244
Mailing address
18608 SE 36TH Cir
Vancouver, WA 98683-8244
Phone (360) 903-4385
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| LW60041917 | Other | WA | LICENSED INDEPENDENT CLINICAL SOCIAL WORKER |
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 |
|---|---|---|---|
| LW 60041917 | WA | MD | Clinical Social Worker |
| 2650 | OR | MD | Occupational Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1128297600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1338422400000",
"number": "1376530584",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "18608 SE 36TH CIR",
"city": "VANCOUVER",
"state": "WA",
"postal_code": "986838244",
"telephone_number": "360-903-4385",
"fax_number": "360-449-0009"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "18608 SE 36TH CIR",
"city": "VANCOUVER",
"state": "WA",
"postal_code": "986838244",
"telephone_number": "360-903-4385",
"fax_number": "360-449-0009"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PAQUETTE",
"first_name": "SIMON",
"middle_name": "B.",
"name_prefix": "Mr.",
"credential": "LCSW",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2005-10-03",
"last_updated": "2012-05-31",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "OR",
"license": "2650",
"primary": true
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "WA",
"license": "LW 60041917",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LICENSED INDEPENDENT CLINICAL SOCIAL WORKER",
"identifier": "LW60041917",
"state": "WA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Vancouver, WA
- Karen N Papania
- Gary W Pape, MD
- Pamela Rae Paprocki-Sims, CDPT
- Paprocki-Sims. LLC (Columbia Treatment Services)
- Jade Paquette
- Jean Michael Paradis, M.D.
- Patti L Paradis
- Tyler Justin Paradis, MD
- Paradox Northwest Associates, Inc (Homewatch Caregivers, Vancouver)
- Paradox Northwest Associates, Inc (Homewatch Caregivers of Southwest Washington)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 31, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.