Kelly Druin, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Practice address

320 Dayton St Ste 127
Edmonds, WA 98020-3590

Phone

(206) 486-0295

NPI assigned

Aug 26, 2010

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other names 1

• Kelly Druin Sievertson Former name

Medicare fee-for-service enrollment

Enrolled in WA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Social Worker

Education

Other, 2006

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

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.

• Crescent Wellness, Inc

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Edmonds, WA
  • NPI 1124594510
  Medicare reassignment Authorized official
• Kelly Druin Sievertson, Licsw

  • Clinic/Center
  • Edmonds, WA
  • NPI 1285010868
  NPD (past)

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

{
    "created_epoch": "1282780800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1653177600000",
    "number": "1649586777",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "320 DAYTON ST STE 127",
            "city": "EDMONDS",
            "state": "WA",
            "postal_code": "980203590",
            "telephone_number": "206-486-0295"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "320 DAYTON ST STE 127",
            "city": "EDMONDS",
            "state": "WA",
            "postal_code": "980203590",
            "telephone_number": "206-486-0295"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DRUIN",
        "first_name": "KELLY",
        "name_prefix": "Mrs.",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-08-26",
        "last_updated": "2022-05-22",
        "certification_date": "2022-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KELLY",
            "last_name": "SIEVERTSON",
            "middle_name": "DRUIN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Dr Kevin Leach PLLC
• Catalina Mariana Draghici, MD
• Jennifer G. Dragoo, LMP
• Stephanie Allison Drake, MSW, MA
• Annabella Drew
• Karli Breanne Dubois, MA, LMHCA
• Jennifer Ducharme, LMP
• Deanna Christine Dudley-Ross, LMFT
• Frank Christopher Duhon, ACUPUNCTURIST
• Jesse C Dunn, LMHC

• Clinical Social Worker in Edmonds, WA
• Providers in Edmonds, WA by specialty
• Clinical Social Worker in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.