Felicia Jean Ackerman, LICSW, SUDP
Individual provider Active NPI Clinical Social Worker · Buckley, WA
NPI 1609118124 · NPPES record last updated Apr 7, 2021
Key facts
- NPI
- 1609118124
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Social Worker 1041C0700X
- License
- LW60751695 (WA)
- Practice address
- 117 S Cedar St
Buckley, WA 98321-1260 - Phone
- (253) 987-6799
- NPI assigned
- Mar 22, 2013
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective May 28, 2022 through May 28, 2028
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| CP60321390 | WA | MD | Addiction (Substance Use Disorder) Counselor |
| LW60751695 | WA | MD | Clinical Social Worker |
| SC60320701 | WA | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Satya Counseling and Wellness LLC | Current |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | CP60321390 | WA | |
| Clinical Social Worker | 1041C0700X | SC60320701 | WA | |
| Clinical Social Worker | 1041C0700X | LW60751695 | WA | Yes |
Addresses
Primary practice location
117 S Cedar St
Buckley, WA 98321-1260
Mailing address
PO Box 260
Buckley, WA 98321-0260
Other providers in Buckley, WA
All providers in Buckley, WA · Clinical Social Worker in Washington
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 7, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Opt Out Affidavits (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.