Individual provider Active NPI

Lucas Steven Brown

  • Clinical Social Worker
  • Puyallup, WA
National Provider Identifier
1578944963
Registry record updated Dec 19, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LW60916054 Issued in WA
Practice address
17404 Meridian E Ste F-117
Puyallup, WA 98375-6234
Phone
(253) 256-3196
Fax
(253) 544-4080
NPI assigned
Jun 11, 2015
Last updated
Dec 19, 2022By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 19, 2022

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 LW60916054 WA Primary

Addresses

Primary practice location

17404 Meridian E Ste F-117
Puyallup, WA 98375-6234

Mailing address

17404 Meridian E Ste F-117
Puyallup, WA 98375-6234
Phone (253) 256-3196

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
I20190813001251 WA Practitioner - Clinical Social Worker 8224365333 Practice locations: Tacoma, WA

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1433980800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1671408000000",
    "number": "1578944963",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17404 MERIDIAN E STE F-117",
            "city": "PUYALLUP",
            "state": "WA",
            "postal_code": "983756234",
            "telephone_number": "253-256-3196",
            "fax_number": "253-544-4080"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17404 MERIDIAN E STE F-117",
            "city": "PUYALLUP",
            "state": "WA",
            "postal_code": "983756234",
            "telephone_number": "253-256-3196",
            "fax_number": "253-544-4080"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROWN",
        "first_name": "LUCAS",
        "middle_name": "STEVEN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-06-11",
        "last_updated": "2022-12-19",
        "certification_date": "2022-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WA",
            "license": "LW60916054",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Puyallup, WA

Sources for this page

Verify at the official NPI Registry.