Kimberly Shea, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

LW60808371 Issued in WA

Practice address

17018 15TH Ave NE
Shoreline, WA 98155

Phone

(206) 362-7282

NPI assigned

Oct 29, 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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Sound

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Tukwila, WA
  • NPI 1780774950
  NPD (past)

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

{
    "created_epoch": "1288310400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1630022400000",
    "number": "1699075242",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3007",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981143007",
            "telephone_number": "206-788-3616",
            "fax_number": "206-652-5216"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17018 15TH AVE NE",
            "city": "SHORELINE",
            "state": "WA",
            "postal_code": "98155",
            "telephone_number": "206-362-7282"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "14270 NE 21st St",
            "address_purpose": "LOCATION",
            "city": "Bellevue",
            "state": "WA",
            "postal_code": "980073720",
            "country_code": "US",
            "telephone_number": "425-653-5000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1539 NE 177th St Ste B",
            "address_purpose": "LOCATION",
            "city": "Shoreline",
            "state": "WA",
            "postal_code": "981555279",
            "country_code": "US",
            "telephone_number": "206-330-9843",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "14270 NE 21st St",
            "address_purpose": "LOCATION",
            "city": "Bellevue",
            "state": "WA",
            "postal_code": "980073720",
            "country_code": "US",
            "telephone_number": "425-653-5000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHEA",
        "first_name": "KIMBERLY",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-10-29",
        "last_updated": "2021-08-27",
        "certification_date": "2021-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "WA",
            "license": "CO61013326",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WA",
            "license": "LW60808371",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Marlene Bowman Sexton, LMFT
• Laxmi Shah, D.C
• Shikha Paresh Shah, MD
• Helena Shaw, OT
• Kristen Anne Shaw
• Reggi Shelley, LMP
• Marissa Shelnut, OTR
• Jennifer Mei Shen, M.D., M.P.H.
• Jeanne Shepard, OTR/L
• Tiffany Lynn Shih, M.D.

• Clinical Social Worker in Shoreline, WA
• Providers in Shoreline, 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 Aug 27, 2021; 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.