Individual provider Active NPI

Maria Campbell Lathrop-Skalos, LCSW, LICSW, BCD

  • Clinical Social Worker
  • Burien, WA
National Provider Identifier
1417135146
Registry record updated Mar 18, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
60870468 Issued in WA
Practice address
15811 Ambaum Blvd SW Ste 110
Burien, WA 98166-3071
Phone
(206) 242-8211
Fax
(206) 242-0162
NPI assigned
Feb 5, 2008
Last updated
Mar 18, 2019By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 18, 2019

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 38131 ID
Clinical Social Worker 1041C0700X 60870468 WA Primary
Clinical Social Worker 1041C0700X 3264 LA

Addresses

Primary practice location

15811 Ambaum Blvd SW Ste 110
Burien, WA 98166-3071

Mailing address

15811 Ambaum Blvd SW Ste 110
Burien, WA 98166-3071
Phone (206) 242-8211

Other practice location 1

112 Mark Twain Dr Apt 26
River Ridge, LA 70123-2452
Phone (504) 239-1974

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
I20191112002521 WA Practitioner - Clinical Social Worker 7517042286 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Counseling Services for Wellbeing, Inc.Group PAC ID 2163641598, 29 clinicians

Practice addresses (Care Compare)

15811 Ambaum Blvd SW
Suite 110
Burien, WA 98166-3071
Phone (206) 242-8211

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3264LAMDProfessional Counselor
38131IDMDClinical Social Worker
60870468WAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Counseling Services for Wellbeing, Inc. CurrentSince Jun 19, 2019 Accepting new patients
R&R Home Care, Inc. Past Accepting new patients

Locations

15811 Ambaum Blvd SW
Ste 110
Burien, WA 98166
Phone (206) 242-8211

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1202169600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1552867200000",
    "number": "1417135146",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15811 AMBAUM BLVD SW STE 110",
            "city": "BURIEN",
            "state": "WA",
            "postal_code": "981663071",
            "telephone_number": "206-242-8211",
            "fax_number": "206-242-0162"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15811 AMBAUM BLVD SW STE 110",
            "city": "BURIEN",
            "state": "WA",
            "postal_code": "981663071",
            "telephone_number": "206-242-8211",
            "fax_number": "206-242-0162"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "112 Mark Twain Dr Apt 26",
            "address_purpose": "LOCATION",
            "city": "River Ridge",
            "state": "LA",
            "postal_code": "701232452",
            "country_code": "US",
            "telephone_number": "504-239-1974",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LATHROP-SKALOS",
        "first_name": "MARIA",
        "middle_name": "CAMPBELL",
        "name_prefix": "Ms.",
        "credential": "LCSW, LICSW, BCD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-02-05",
        "last_updated": "2019-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "ID",
            "license": "38131",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WA",
            "license": "60870468",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "LA",
            "license": "3264",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Burien, WA

Sources for this page

Verify at the official NPI Registry.