Individual provider Active NPI

Rebecca Ellen Samelson, LICSW

  • Social Worker
  • Seattle, WA
National Provider Identifier
1528630951
Registry record updated Jul 14, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
LW61139536 Issued in WA
Practice address
4400 37TH Ave S
Seattle, WA 98118-1609
Phone
(206) 461-6957
Fax
(206) 461-7810
NPI assigned
Jul 14, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 14, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X LW61139536 WA Primary

Addresses

Primary practice location

4400 37TH Ave S
Seattle, WA 98118-1609

Mailing address

1200 12TH Ave S Ste 901
Seattle, WA 98144-2712

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
I20240403003964 WA Practitioner - Clinical Social Worker 0244678605 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Neighborcare HealthGroup PAC ID 0143134205, 100 clinicians

Practice addresses (Care Compare)

10521 Meridian Ave N
Seattle, WA 98133-9509
Phone (206) 296-4990

4400 37TH Ave S
Seattle, WA 98118-1609
Phone (206) 461-6957

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LW61139536WAMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Neighborcare Health CurrentSince Feb 27, 2024 Accepting new patients
Neighborcare Health CurrentSince Feb 27, 2024 Accepting new patients
Neighborcare Health Current Accepting new patients

Locations

1629 N 45th St
Seattle, WA 98103
Phone (206) 633-3350

4400 37th Ave S
Seattle, WA 98118
Phone (206) 296-4650

1200 12th Ave S
Ste 901
Seattle, WA 98144
Phone (206) 548-3058

12721 30th Ave NE
Ste 101
Seattle, WA 98125
Phone (206) 417-0326

9245 Rainier Ave S
Seattle, WA 98118
Phone (206) 461-6981

6020 35th Ave SW
Seattle, WA 98126
Phone (206) 461-6950

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1626220800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626220800000",
    "number": "1528630951",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 12TH AVE S STE 901",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981442712"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4400 37TH AVE S",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981181609",
            "telephone_number": "206-461-6957",
            "fax_number": "206-461-7810"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAMELSON",
        "first_name": "REBECCA",
        "middle_name": "ELLEN",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-07-14",
        "last_updated": "2021-07-14",
        "certification_date": "2021-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "WA",
            "license": "LW61139536",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Seattle, WA

Sources for this page

Verify at the official NPI Registry.