Jordan Si Dennison, LCSW, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

LW61254381 Issued in WA

Practice address

7100 Fort Dent Way
Tukwila, WA 98188-7500

Phone

(206) 708-7274

NPI assigned

Jun 9, 2017

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in CO, WA, CA3 enrollments

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 3

Specialty

Clinical Social Worker

Education

Other, 2018

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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

• Mindful Therapy Group PC

  • Clinical Social Worker
  • Mountlake Terrace, WA
  • NPI 1316238678
  Medicare reassignment NPD
• Sondermind PC

  • Clinical Social Worker
  • San Jose, CA
  • NPI 1003646977
  Medicare reassignment NPD
• Sondermind Provider Network LLC

  • Clinical Social Worker
  • Denver, CO
  • NPI 1760854442
  Medicare reassignment NPD
• Sondermind, P.a.

  • Clinical Social Worker
  • Wichita, KS
  • NPI 1710647581

  WA

  Medicare reassignment NPD
• Anchored Psychiatry, PLLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Kennewick, WA
  • NPI 1942927710
  NPD

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

{
    "created_epoch": "1496966400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649808000000",
    "number": "1477082626",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "748 MARKET ST # 136",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984023737",
            "telephone_number": "719-338-6131"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7100 FORT DENT WAY",
            "city": "TUKWILA",
            "state": "WA",
            "postal_code": "981887500",
            "telephone_number": "206-708-7274"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5107 N 47th St",
            "address_purpose": "LOCATION",
            "city": "Tacoma",
            "state": "WA",
            "postal_code": "984073813",
            "country_code": "US",
            "telephone_number": "303-504-8996",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4455 E 12th Ave",
            "address_purpose": "LOCATION",
            "city": "Denver",
            "state": "CO",
            "postal_code": "802202415",
            "country_code": "US",
            "telephone_number": "303-504-7936",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1355 S Colorado Blvd",
            "address_purpose": "LOCATION",
            "city": "Denver",
            "state": "CO",
            "postal_code": "80222",
            "country_code": "US",
            "telephone_number": "303-756-9052",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1355 S Colorado Blvd",
            "address_purpose": "LOCATION",
            "city": "Denver",
            "state": "CO",
            "postal_code": "802223305",
            "country_code": "US",
            "telephone_number": "303-756-9052",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1355 S Colorado Blvd",
            "address_purpose": "LOCATION",
            "city": "Denver",
            "state": "CO",
            "postal_code": "802223305",
            "country_code": "US",
            "telephone_number": "303-756-9052",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DENNISON",
        "first_name": "JORDAN",
        "middle_name": "SI",
        "credential": "LCSW, LICSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-06-09",
        "last_updated": "2022-04-13",
        "certification_date": "2022-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CO",
            "license": "09926943",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WA",
            "license": "LW61254381",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Valory P. Delucia, MD
• Kaydee Dempsey
• Polly Anna Denison
• Dennis P. Nordlund, DDS
• Jerome Dennis
• Department of Social and Health Services
• Department of Social and Health Services
• Audrey Deppe
• Lisa Depriest, PHARMACY TEHNICIAN
• Edward A Desano III, BSP,RC

• Clinical Social Worker in Tukwila, WA
• Providers in Tukwila, WA by specialty
• Clinical Social Worker in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2022; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.