Active NPI
Caroline Cruse, MSW, LICSW, CMHS
- Social Worker
- Mount Vernon, WA
National Provider Identifier
1679190797
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- LW61446566
- Practice address
- 1311 E Division St
Mount Vernon, WA 98274-4134 - Phone
- (360) 300-5755
- Fax
- (360) 276-6450
- NPI assigned
- Jul 6, 2020
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | LW61446566 | WA | Primary |
Addresses
Primary practice location
1311 E Division St
Mount Vernon, WA 98274-4134
Mailing address
PO Box 257 PMB 9911
Olympia, WA 98507
Phone (360) 300-5755
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Dec 28, 2023 through Dec 28, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LW61446566 | WA | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1593993600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1707264000000",
"number": "1679190797",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 257 PMB 9911",
"city": "OLYMPIA",
"state": "WA",
"postal_code": "98507",
"telephone_number": "360-300-5755",
"fax_number": "360-276-6450"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1311 E DIVISION ST",
"city": "MOUNT VERNON",
"state": "WA",
"postal_code": "982744134",
"telephone_number": "360-300-5755",
"fax_number": "360-276-6450"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CRUSE",
"first_name": "CAROLINE",
"credential": "MSW, LICSW, CMHS",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-07-06",
"last_updated": "2024-02-07",
"certification_date": "2024-02-07",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "WA",
"license": "LW61446566",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mount Vernon, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.