Individual provider Active NPI

Barbara Gustafson O'Brien, M.S.S.W.

  • Clinical Social Worker
  • Seattle, WA
National Provider Identifier
1528134376
Registry record updated Sep 26, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LW00006035 Issued in WA
Practice address
4510 Thackeray PL NE
Seattle, WA 98105-4842
Phone
(206) 963-0201
NPI assigned
Nov 24, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 26, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X LW00006035 WA Primary

Addresses

Primary practice location

4510 Thackeray PL NE
Seattle, WA 98105-4842

Mailing address

7316 50TH Ave NE
Seattle, WA 98115-6130
Phone (206) 325-4852

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Jul 21, 2023 through Jul 21, 2027

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
LW00006035WAMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1164326400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695686400000",
    "number": "1528134376",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7316 50TH AVE NE",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981156130",
            "telephone_number": "206-325-4852",
            "fax_number": "206-524-1998"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4510 THACKERAY PL NE",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981054842",
            "telephone_number": "206-963-0201"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "O'BRIEN",
        "first_name": "BARBARA",
        "middle_name": "GUSTAFSON",
        "name_prefix": "Ms.",
        "credential": "M.S.S.W.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-24",
        "last_updated": "2023-09-26",
        "certification_date": "2023-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WA",
            "license": "LW00006035",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Seattle, WA

Sources for this page

Verify at the official NPI Registry.