Individual provider Active NPI

Margaret Moudry, MSW, LICSW

  • Clinical Social Worker
  • Bellingham, WA
National Provider Identifier
1386096543
Registry record updated Jul 11, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
00005712 Issued in WA
Practice address
203 W Holly St Ste 331
Bellingham, WA 98225-4379
Phone
(360) 303-3616
Fax
(360) 715-3483
NPI assigned
Jul 11, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 11, 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 00005712 WA Primary

Addresses

Primary practice location

203 W Holly St Ste 331
Bellingham, WA 98225-4379

Mailing address

203 W Holly St Ste 331
Bellingham, WA 98225-4379

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
I20220125001318 WA Practitioner - Clinical Social Worker 7810389889 Practice locations: Bellingham, WA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1200 Harris Ave
Suite 402
Bellingham, WA 98225-7146
Phone (360) 303-3616

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
00005712WAMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1468195200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1468195200000",
    "number": "1386096543",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "203 W HOLLY ST STE 331",
            "city": "BELLINGHAM",
            "state": "WA",
            "postal_code": "982254379"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "203 W HOLLY ST STE 331",
            "city": "BELLINGHAM",
            "state": "WA",
            "postal_code": "982254379",
            "telephone_number": "360-303-3616",
            "fax_number": "360-715-3483"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOUDRY",
        "first_name": "MARGARET",
        "credential": "MSW, LICSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-07-11",
        "last_updated": "2016-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WA",
            "license": "00005712",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bellingham, WA

Sources for this page

Verify at the official NPI Registry.