Individual provider Active NPI

August Kelemen-Eberhart, LSWAIC

  • Social Worker
  • Port Orchard, WA
National Provider Identifier
1417466178
Registry record updated Oct 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
SWIA.SC.61315907 Issued in WA
Practice address
104 Tremont St Ste 201
Port Orchard, WA 98366-3765
Phone
(360) 698-9258
NPI assigned
Sep 26, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 8, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Community Health Worker 172V00000X
Social Worker 104100000X SWIA.SC.61315907 WA Primary

Addresses

Primary practice location

104 Tremont St Ste 201
Port Orchard, WA 98366-3765

Mailing address

9434 36TH Ave SW
Seattle, WA 98126-3831
Phone (206) 683-7664

Other identifiers 1

IdentifierTypeStateIssuer
SWIA.SC.61315907OtherWAWASHINGTON STATE DEPARTMENT OF HEALTH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
SWIA.SC.61315907WAMDSocial Worker

NPI Registry JSON

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

{
    "created_epoch": "1506384000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759881600000",
    "number": "1417466178",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9434 36TH AVE SW",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981263831",
            "telephone_number": "206-683-7664"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "104 TREMONT ST STE 201",
            "city": "PORT ORCHARD",
            "state": "WA",
            "postal_code": "983663765",
            "telephone_number": "360-698-9258"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELEMEN-EBERHART",
        "first_name": "AUGUST",
        "credential": "LSWAIC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-09-26",
        "last_updated": "2025-10-08",
        "certification_date": "2025-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "172V00000X",
            "taxonomy_group": "",
            "desc": "Community Health Worker",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "WA",
            "license": "SWIA.SC.61315907",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WASHINGTON STATE DEPARTMENT OF HEALTH",
            "identifier": "SWIA.SC.61315907",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Orchard, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2025; 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.