Individual provider Active NPI

Mariana Leigh Weller, MSW

  • Clinical Social Worker
  • Seattle, WA
National Provider Identifier
1376990721
Registry record updated May 16, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
SA 60640671 Issued in WA
Practice address
1600 E Olive St
Sound Mental Health
Seattle, WA 98122-2735
Phone
(206) 302-2200
Fax
(206) 302-2210
NPI assigned
May 16, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 16, 2016

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 SA 60640671 WA Primary

Addresses

Primary practice location

1600 E Olive St
Sound Mental Health
Seattle, WA 98122-2735

Mailing address

1600 E Olive St
Sound Mental Health
Seattle, WA 98122-2735
Phone (206) 302-2200

Other names 1

  • Mariana Leigh Grala Former name

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20190712002459 WA Practitioner - Clinical Social Worker 1254666258 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
SA 60640671WAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Mindful Therapy Group PC Clinical CurrentSince Jun 14, 2019 Accepting new patients

Locations

6505 216th St SW
Ste 100
Mountlake Terrace, WA 98043
Phone (425) 678-6463

21907 64th Ave W
Ste 200
Mountlake Terrace, WA 98043
Phone (410) 258-3698

320 NE 97th St
Ste A
Seattle, WA 98115
Phone (206) 323-8113

7100 Fort Dent Way
Ste 220
Tukwila, WA 98188
Phone (206) 708-7274

Organizations & group practices 1

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": "1463356800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1463356800000",
    "number": "1376990721",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1600 E OLIVE ST",
            "address_2": "SOUND MENTAL HEALTH",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981222735",
            "telephone_number": "206-302-2200",
            "fax_number": "206-302-2210"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 E OLIVE ST",
            "address_2": "SOUND MENTAL HEALTH",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981222735",
            "telephone_number": "206-302-2200",
            "fax_number": "206-302-2210"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WELLER",
        "first_name": "MARIANA",
        "middle_name": "LEIGH",
        "credential": "MSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-05-16",
        "last_updated": "2016-05-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WA",
            "license": "SA 60640671",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARIANA",
            "last_name": "GRALA",
            "middle_name": "LEIGH",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Seattle, WA

Sources for this page

Verify at the official NPI Registry.