Active NPI
Kathleen M. Chandler, LICSW
- Clinical Social Worker
- Vashon, WA
National Provider Identifier
1407545619
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 61417949
- Practice address
- 16305 Crescent Dr SW
Vashon, WA 98070-3742 - Phone
- (206) 787-0178
- NPI assigned
- May 3, 2023
- Last updated
- Dec 20, 2024
- 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 |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 61417949 | WA | Primary |
Addresses
Primary practice location
16305 Crescent Dr SW
Vashon, WA 98070-3742
Mailing address
16305 Crescent Dr SW
Vashon, WA 98070-3742
Phone (206) 787-0178
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Dec 17, 2024 through Dec 17, 2026
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 61417949 | WA | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1683072000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1734652800000",
"number": "1407545619",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "16305 CRESCENT DR SW",
"city": "VASHON",
"state": "WA",
"postal_code": "980703742",
"telephone_number": "206-787-0178"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "16305 CRESCENT DR SW",
"city": "VASHON",
"state": "WA",
"postal_code": "980703742",
"telephone_number": "206-787-0178"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHANDLER",
"first_name": "KATHLEEN",
"middle_name": "M.",
"credential": "LICSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2023-05-03",
"last_updated": "2024-12-20",
"certification_date": "2024-12-20",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "WA",
"license": "61417949",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Vashon, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.