Idil Mohamud, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

LW60290156 Issued in WA

Practice address

310 3Rd Ave NE Ste 109
Issaquah, WA 98027-3346

Phone

(425) 588-0800

NPI assigned

Nov 9, 2024

Last updated

Nov 22, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Recenter Self

  • Counselor
  • Issaquah, WA
  • NPI 1619595311
  NPD (past)

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

{
    "created_epoch": "1731110400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732233600000",
    "number": "1538983341",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "310 3RD AVE NE STE 109",
            "city": "ISSAQUAH",
            "state": "WA",
            "postal_code": "980273346",
            "telephone_number": "425-588-0800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "310 3RD AVE NE STE 109",
            "city": "ISSAQUAH",
            "state": "WA",
            "postal_code": "980273346",
            "telephone_number": "425-588-0800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOHAMUD",
        "first_name": "IDIL",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-11-09",
        "last_updated": "2024-11-22",
        "certification_date": "2024-11-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WA",
            "license": "LW60290156",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jeffrey George Mitsch, MSPT
• Janet Moczulewski, LMFT
• Jill Marie Moeller, LICSW
• Rehab Elsayed Morsi Mohamed
• Shadi Mohammadi Araghi, D.D.S
• Micah N. Mohler, PA-C
• Edwin Mok, RPH
• Kelley Molinari, LMFT
• Emelia M Monahan
• Rick Monce, MA

• Clinical Social Worker in Issaquah, WA
• Providers in Issaquah, 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 Nov 22, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.