Active NPI
Kelly Watt, LICSW
- Clinical Social Worker
- Poulsbo, WA
National Provider Identifier
1467197939
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- LW61516067
- Practice address
- 1611 England LN NW
Poulsbo, WA 98370-9456 - Phone
- (206) 659-6527
- NPI assigned
- Apr 29, 2022
- Sex
- Female
- Sole proprietor
- No
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 | LW61516067 | WA | Primary |
Addresses
Primary practice location
1611 England LN NW
Poulsbo, WA 98370-9456
Mailing address
4526 Federal Ave
Everett, WA 98203-2132
Phone (425) 349-6200
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LW61516067 | WA | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1651190400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1781136000000",
"number": "1467197939",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4526 FEDERAL AVE",
"city": "EVERETT",
"state": "WA",
"postal_code": "982032132",
"telephone_number": "425-349-6200"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1611 ENGLAND LN NW",
"city": "POULSBO",
"state": "WA",
"postal_code": "983709456",
"telephone_number": "206-659-6527"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WATT",
"first_name": "KELLY",
"credential": "LICSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-04-29",
"last_updated": "2026-06-11",
"certification_date": "2026-06-11",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "WA",
"license": "LW61516067",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Poulsbo, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.