Active NPI
Ti Jane' Nelson
- Social Worker
- Kennewick, WA
National Provider Identifier
1376895193
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- SC 60287541
- Practice address
- 2810 W Clearwater Ave
Suite 103
Kennewick, WA 99336-2963 - Phone
- (509) 783-7333
- Fax
- (509) 783-1980
- NPI assigned
- Oct 3, 2012
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Social Worker | 104100000X | SC 60287541 | WA | Primary |
Addresses
Primary practice location
2810 W Clearwater Ave
Suite 103
Kennewick, WA 99336-2963
Mailing address
2810 W Clearwater Ave
Suite 103
Kennewick, WA 99336-2963
Phone (509) 783-7333
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 |
|---|---|---|---|
| SC 60287541 | WA | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1349222400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1349222400000",
"number": "1376895193",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2810 W CLEARWATER AVE",
"address_2": "SUITE 103",
"city": "KENNEWICK",
"state": "WA",
"postal_code": "993362963",
"telephone_number": "509-783-7333",
"fax_number": "509-783-1980"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2810 W CLEARWATER AVE",
"address_2": "SUITE 103",
"city": "KENNEWICK",
"state": "WA",
"postal_code": "993362963",
"telephone_number": "509-783-7333",
"fax_number": "509-783-1980"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NELSON",
"first_name": "TI",
"middle_name": "JANE'",
"name_prefix": "Ms.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2012-10-03",
"last_updated": "2012-10-03",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "WA",
"license": "SC 60287541",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Kennewick, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 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.