Individual provider Active NPI

Skylar Liam Newkirk, LICSW

  • Clinical Social Worker
  • Vancouver, WA
National Provider Identifier
1558870832
Registry record updated Feb 2, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LW60821834 Issued in WA
Practice address
2415 NE 134TH St Ste 301
Vancouver, WA 98686-3029
Phone
(360) 882-2778
NPI assigned
Sep 29, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 2, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X SC60503902 WA
Clinical Social Worker 1041C0700X LW60821834 WA Primary

Addresses

Primary practice location

2415 NE 134TH St Ste 301
Vancouver, WA 98686-3029

Mailing address

PO Box 4825
Portland, OR 97208-4825
Phone (360) 882-2778

Other practice location 1

5611 Bayview Rd
Langley, WA 98260-9735
Phone (417) 225-8288

Other practice location 2

317 Sanders Way
Goldendale, WA 98620-9059
Phone (509) 773-2732

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
I20181024000224 WA Practitioner - Clinical Social Worker 9931452893 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
Telehealth
Offers telehealth services
Group practices
The Vancouver Clinic Inc PSGroup PAC ID 3173436490, 580 clinicians

Practice addresses (Care Compare)

2525 NE 139TH St
Vancouver, WA 98686-2719
Phone (360) 882-2778

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
SC60503902WAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
The Vancouver Clinic Inc PS CurrentSince Jan 23, 2023 Accepting new patients
The Vancouver Clinic Inc PS CurrentSince Jan 23, 2023 Accepting new patients
The Vancouver Clinic Inc PS Current Accepting new patients

Locations

2525 NE 139th St
Vancouver, WA 98686
Phone (360) 397-1500

2415 NE 134th St
Ste 301
Vancouver, WA 98686
Phone (360) 576-3354

700 NE 87th Ave
Vancouver, WA 98664
Phone (360) 397-1500

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": "1506643200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675296000000",
    "number": "1558870832",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4825",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972084825",
            "telephone_number": "360-882-2778"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2415 NE 134TH ST STE 301",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986863029",
            "telephone_number": "360-882-2778"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5611 Bayview Rd",
            "address_purpose": "LOCATION",
            "city": "Langley",
            "state": "WA",
            "postal_code": "982609735",
            "country_code": "US",
            "telephone_number": "417-225-8288",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "317 Sanders Way",
            "address_purpose": "LOCATION",
            "city": "Goldendale",
            "state": "WA",
            "postal_code": "986209059",
            "country_code": "US",
            "telephone_number": "509-773-2732",
            "fax_number": "509-773-2733",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NEWKIRK",
        "first_name": "SKYLAR",
        "middle_name": "LIAM",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-09-29",
        "last_updated": "2023-02-02",
        "certification_date": "2023-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WA",
            "license": "SC60503902",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WA",
            "license": "LW60821834",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vancouver, WA

Sources for this page

Verify at the official NPI Registry.