Individual provider Active NPI

Cara A Gresham, MSW, SUDP, LICSW

  • Social Worker
  • Bellingham, WA
National Provider Identifier
1669706594
Registry record updated May 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
LW60661788 Issued in WA
Practice address
2608 Kwina Rd
Bellingham, WA 98226-9291
Phone
(360) 312-2000
NPI assigned
Sep 24, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 7, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X CP 60416986 WA
Social Worker 104100000X LW60661788 WA Primary

Addresses

Primary practice location

2608 Kwina Rd
Bellingham, WA 98226-9291

Mailing address

2592 Kwina Rd
Bellingham, WA 98226-9278

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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

Enrollment IDStateProvider typePAC IDDetails
I20240522001811 TX Practitioner - Clinical Social Worker 3577850668 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Lummi Indian Business CouncilGroup PAC ID 5395738231, 26 clinicians

Practice addresses (Care Compare)

2592 Kwina Rd
Bellingham, WA 98226-9278
Phone (360) 312-2489

2608 Kwina Rd
Bellingham, WA 98226-9291
Phone (360) 384-0464

2665 Kwina Rd
Bellingham, WA 98226-9291
Phone (360) 312-2489

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CP 60416986WAMDAddiction (Substance Use Disorder) Counselor
LW60661788WAMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Lummi Indian Business Council CurrentSince May 1, 2024 Accepting new patients
Lummi Indian Business Council CurrentSince May 1, 2024 Accepting new patients
Sea-Mar Community Health Center Past Accepting new patients

Locations

2592 Kwina Rd
Bellingham, WA 98226
Phone (360) 312-2000

Organizations & group practices 3

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": "1253750400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715040000000",
    "number": "1669706594",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2592 KWINA RD",
            "city": "BELLINGHAM",
            "state": "WA",
            "postal_code": "982269278"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2608 KWINA RD",
            "city": "BELLINGHAM",
            "state": "WA",
            "postal_code": "982269291",
            "telephone_number": "360-312-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRESHAM",
        "first_name": "CARA",
        "middle_name": "A",
        "credential": "MSW, SUDP, LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-09-24",
        "last_updated": "2024-05-07",
        "certification_date": "2024-05-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "WA",
            "license": "CP 60416986",
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "WA",
            "license": "LW60661788",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bellingham, WA

Sources for this page

Verify at the official NPI Registry.