Individual provider Active NPI

Maria Villegas, LICSW

  • Clinical Social Worker
  • Vancouver, WA
National Provider Identifier
1619434958
Registry record updated Feb 22, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
60649716 Issued in WA
Practice address
101 E 8TH St Ste 110
Vancouver, WA 98660-3294
Phone
(206) 604-2852
NPI assigned
Feb 22, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 22, 2019

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 60649716 WA Primary

Addresses

Primary practice location

101 E 8TH St Ste 110
Vancouver, WA 98660-3294

Mailing address

9126 N Ida Ave
Portland, OR 97203-6237
Phone (206) 604-2852

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
60649716WAMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1550793600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1550793600000",
    "number": "1619434958",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9126 N IDA AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972036237",
            "telephone_number": "206-604-2852"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 E 8TH ST STE 110",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986603294",
            "telephone_number": "206-604-2852"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VILLEGAS",
        "first_name": "MARIA",
        "credential": "LICSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-02-22",
        "last_updated": "2019-02-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WA",
            "license": "60649716",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vancouver, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 2019; 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.