Individual provider Active NPI

Elizabeth Mendus

  • Clinical Social Worker
  • Tacoma, WA
National Provider Identifier
1548818404
Registry record updated Jul 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LW61507471 Issued in WA
Practice address
950 Broadway Ste 404
Tacoma, WA 98402-4454
Phone
(425) 640-7009
NPI assigned
Sep 3, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 16, 2024

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X CG61001644 WA
Clinical Social Worker 1041C0700X SC61108679 WA
Student in an Organized Health Care Education/Training Program 390200000X
Clinical Social Worker 1041C0700X LW61507471 WA Primary

Addresses

Primary practice location

950 Broadway Ste 404
Tacoma, WA 98402-4454

Mailing address

100 N Howard St Ste W
Spokane, WA 99201-0508
Phone (425) 640-7009

Other names 1

  • Elizabeth Anderson-Krengel Former name

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
I20241107003777 WA Practitioner - Clinical Social Worker 4688108020 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CG61001644WAMDCounselor
SC61108679WAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Mindful Therapy Group PC Clinical CurrentSince Nov 1, 2024 Accepting new patients

Locations

21907 64th Ave W
Ste 200
Mountlake Terrace, WA 98043
Phone (410) 258-3698

6505 216th St SW
Ste 100
Mountlake Terrace, WA 98043
Phone (425) 678-6463

101 Elliott Ave W
Ste 500
Seattle, WA 98119
Phone (206) 708-6432

320 NE 97th St
Ste A
Seattle, WA 98115
Phone (206) 323-8113

201 W North River Dr
Ste 301
Spokane, WA 99201
Phone (509) 496-0724

950 Broadway
Ste 404
Tacoma, WA 98402
Phone (206) 774-8557

Organizations & group practices 1

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": "1567468800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721088000000",
    "number": "1548818404",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 N HOWARD ST STE W",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992010508",
            "telephone_number": "425-640-7009"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "950 BROADWAY STE 404",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984024454",
            "telephone_number": "425-640-7009"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MENDUS",
        "first_name": "ELIZABETH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-09-03",
        "last_updated": "2024-07-16",
        "certification_date": "2024-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "WA",
            "license": "CG61001644",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WA",
            "license": "SC61108679",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WA",
            "license": "LW61507471",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ELIZABETH",
            "last_name": "ANDERSON-KRENGEL",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Tacoma, WA

Sources for this page

Verify at the official NPI Registry.