Individual provider Active NPI

Rachelle Ballmer, LICSW

  • Clinical Social Worker
  • Seattle, WA
National Provider Identifier
1629258405
Registry record updated Jul 18, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LW00005902 Issued in WA
Practice address
753 N 35TH St
Suite 102
Seattle, WA 98103-8870
Phone
(206) 321-1299
Fax
(206) 985-2698
NPI assigned
Nov 8, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 18, 2008

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 LW00005902 WA Primary

Addresses

Primary practice location

753 N 35TH St
Suite 102
Seattle, WA 98103-8870

Mailing address

PO Box 14435
Seattle, WA 98114-0435
Phone (206) 321-1299

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
LW00005902WAMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1194480000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1216339200000",
    "number": "1629258405",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 14435",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981140435",
            "telephone_number": "206-321-1299",
            "fax_number": "206-985-2698"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "753 N 35TH ST",
            "address_2": "SUITE 102",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981038870",
            "telephone_number": "206-321-1299",
            "fax_number": "206-985-2698"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BALLMER",
        "first_name": "RACHELLE",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-11-08",
        "last_updated": "2008-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WA",
            "license": "LW00005902",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Seattle, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2008; 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.