Individual provider Active NPI

Kelsey Baylor, LICSW-A

  • Clinical Social Worker
  • Spokane, WA
National Provider Identifier
1649008194
Registry record updated Jul 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
SC.61559246 Issued in WA
Practice address
1212 N Washington St Ste 204
Spokane, WA 99201-2401
Phone
(509) 701-3180
Fax
(509) 267-2717
NPI assigned
Jul 25, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 25, 2024

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 SC.61559246 WA Primary

Addresses

Primary practice location

1212 N Washington St Ste 204
Spokane, WA 99201-2401

Mailing address

1816 S Wardson St
Spokane Valley, WA 99212-3223
Phone (509) 701-3180

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
SC.61559246WAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Grassroots Therapy Group LLC Clinical CurrentSince Jul 28, 2024 Accepting new patients

Locations

1212 N Washington St
Ste 204
Spokane, WA 99201
Phone (509) 290-5954

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1721865600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721865600000",
    "number": "1649008194",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1816 S WARDSON ST",
            "city": "SPOKANE VALLEY",
            "state": "WA",
            "postal_code": "992123223",
            "telephone_number": "509-701-3180",
            "fax_number": "509-267-2717"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1212 N WASHINGTON ST STE 204",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992012401",
            "telephone_number": "509-701-3180",
            "fax_number": "509-267-2717"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAYLOR",
        "first_name": "KELSEY",
        "credential": "LICSW-A",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-07-25",
        "last_updated": "2024-07-25",
        "certification_date": "2024-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WA",
            "license": "SC.61559246",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Spokane, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2024; 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.