Individual provider Active NPI

Aileen Marie Hetrick, MSW

  • Social Worker
  • Spokane Valley, WA
National Provider Identifier
1427343169
Registry record updated May 19, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
LW60584181 Issued in WA
Practice address
16528 E Desmet CT Ste B2100
Spokane Valley, WA 99216-3522
Phone
(509) 944-9440
Fax
(509) 474-6606
NPI assigned
Jun 10, 2011
Last updated
May 19, 2021By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 19, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X LW60584181 WA Primary
Clinical Social Worker 1041C0700X LW60584181 WA
School Social Worker 1041S0200X

Addresses

Primary practice location

16528 E Desmet CT Ste B2100
Spokane Valley, WA 99216-3522

Mailing address

107 S Division St
Spokane, WA 99202-1510
Phone (509) 838-4651

Other identifiers 1

IdentifierTypeStateIssuer
1427343169MedicaidWA

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address ahetrick991668@wm.providencedirect.org Direct

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
I20151119002146 WA Practitioner - Clinical Social Worker 5698075810 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Colville Medical Center PSGroup PAC ID 6709774086, 26 clinicians
Wellness Therapies LLCGroup PAC ID 8426384124, 7 clinicians

Practice addresses (Care Compare)

1200 E Columbia Ave
Colville, WA 99114-3354

16528 E Desmet CT
Suite B2100
Spokane Valley, WA 99216-3522
Phone (509) 944-9440

421 W Riverside Ave
Suite 1600
Spokane, WA 99201-0406
Phone (509) 481-9629

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LW60584181WAMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Health & Services Washington Social Worker CurrentSince Feb 18, 2019 Accepting new patients
Providence Health & Services Washington CurrentSince Feb 18, 2019 Accepting new patients
Wellness Therapies, LLC Clinical CurrentSince Oct 1, 2021 Accepting new patients

Locations

1200 E Columbia Ave
Colville, WA 99114
Phone (509) 684-3701

421 W Riverside Ave
Ste 1600
Spokane, WA 99201
Phone (509) 481-9629

421 W Riverside Ave
Ste 340
Spokane, WA 99201
Phone (509) 563-7081

16528 E Desmet Ct
Ste B2100
Spokane Valley, WA 99216
Phone (509) 940-9440

Organizations & group practices 3

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": "1307664000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1621382400000",
    "number": "1427343169",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "107 S DIVISION ST",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992021510",
            "telephone_number": "509-838-4651",
            "fax_number": "509-363-2762"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16528 E DESMET CT STE B2100",
            "city": "SPOKANE VALLEY",
            "state": "WA",
            "postal_code": "992163522",
            "telephone_number": "509-944-9440",
            "fax_number": "509-474-6606"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HETRICK",
        "first_name": "AILEEN",
        "middle_name": "MARIE",
        "credential": "MSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-06-10",
        "last_updated": "2021-05-19",
        "certification_date": "2021-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "WA",
            "license": "LW60584181",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WA",
            "license": "LW60584181",
            "primary": false
        },
        {
            "code": "1041S0200X",
            "taxonomy_group": "",
            "desc": "Social Worker, School",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1427343169",
            "state": "WA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ahetrick991668@wm.providencedirect.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "16528 E Desmet Ct Ste B2100",
            "city": "Spokane Valley",
            "state": "WA",
            "country_code": "US",
            "postal_code": "992163522",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Spokane Valley, WA

Sources for this page

Verify at the official NPI Registry.