Individual provider Active NPI

Genna Brodsky Chase, LICSW

  • Clinical Social Worker
  • Olympia, WA
National Provider Identifier
1629340989
Registry record updated Jun 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
61154029 Issued in WA
Practice address
222 Kenyon St NW
Suite #1
Olympia, WA 98502
Phone
(925) 338-9817
NPI assigned
Feb 2, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 7, 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 29394 CA
Clinical Social Worker 1041C0700X 61154029 WA Primary

Addresses

Primary practice location

222 Kenyon St NW
Suite #1
Olympia, WA 98502

Mailing address

120 State Ave NE
PMB #203
Olympia, WA 98501-1131
Phone (925) 338-9817

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
61154029WAMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1328140800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686096000000",
    "number": "1629340989",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 STATE AVE NE",
            "address_2": "PMB #203",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "985011131",
            "telephone_number": "925-338-9817"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "222 KENYON ST NW",
            "address_2": "SUITE #1",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "98502",
            "telephone_number": "925-338-9817"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRODSKY CHASE",
        "first_name": "GENNA",
        "credential": "LICSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-02-02",
        "last_updated": "2023-06-07",
        "certification_date": "2023-05-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "29394",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WA",
            "license": "61154029",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Olympia, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 2023; 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.