NPIMap

Organization Active NPI

Robert Perry, Licsw, PLLC

  • Clinical Social Worker
  • Port Angeles, WA
National Provider Identifier
1417325523
Registry record updated Jan 9, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LW60080835 Issued in WA
Legal business name
ROBERT PERRY, LICSW, PLLC
Practice address
1225 E Front St
Port Angeles, WA 98362-4309
Phone
(360) 477-6104
NPI assigned
Sep 4, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 9, 2023

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

Authorized official

Name
Mr. Robert Perry, LICSW
Title
Sole Member / Social Work Provider
Phone
(360) 477-6104

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 1041C0700X LW60080835 WA Primary

Addresses

Primary practice location

1225 E Front St
Port Angeles, WA 98362-4309

Mailing address

PO Box 3062
Port Angeles, WA 98362-0339
Phone (360) 477-6104

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1441324800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1673222400000",
    "number": "1417325523",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3062",
            "city": "PORT ANGELES",
            "state": "WA",
            "postal_code": "983620339",
            "telephone_number": "360-477-6104"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1225 E FRONT ST",
            "city": "PORT ANGELES",
            "state": "WA",
            "postal_code": "983624309",
            "telephone_number": "360-477-6104"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROBERT PERRY, LICSW, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-09-04",
        "last_updated": "2023-01-09",
        "certification_date": "2023-01-09",
        "status": "A",
        "authorized_official_last_name": "PERRY",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_title_or_position": "SOLE MEMBER / SOCIAL WORK PROVIDER",
        "authorized_official_telephone_number": "360-477-6104",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "LICSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "WA",
            "license": "LW60080835",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Angeles, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.