Individual provider Active NPI

Galen Reeves Kerrick

  • Clinical Social Worker
  • Seattle, WA
National Provider Identifier
1699241679
Registry record updated Feb 4, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LW61365197 Issued in WA
Practice address
2400 NE 95TH St
Seattle, WA 98115-2426
Phone
(206) 525-5050
NPI assigned
Oct 17, 2018
Last updated
Feb 4, 2025By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 4, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X CG60883715 WA
Developmental Therapist 222Q00000X CG60883715 WA
Clinical Social Worker 1041C0700X LW61365197 WA Primary

Addresses

Primary practice location

2400 NE 95TH St
Seattle, WA 98115-2426

Mailing address

37 Village GRN N Apt B
Riverside, RI 02915-3912
Phone (206) 790-9588

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
CG60883715WAMDCounselor
LW61365197WAMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1539734400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738627200000",
    "number": "1699241679",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "37 VILLAGE GRN N APT B",
            "city": "RIVERSIDE",
            "state": "RI",
            "postal_code": "029153912",
            "telephone_number": "206-790-9588"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2400 NE 95TH ST",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981152426",
            "telephone_number": "206-525-5050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KERRICK",
        "first_name": "GALEN",
        "middle_name": "REEVES",
        "name_prefix": "Mr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-10-17",
        "last_updated": "2025-02-04",
        "certification_date": "2025-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "WA",
            "license": "CG60883715",
            "primary": false
        },
        {
            "code": "222Q00000X",
            "taxonomy_group": "",
            "desc": "Developmental Therapist",
            "state": "WA",
            "license": "CG60883715",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WA",
            "license": "LW61365197",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Seattle, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2025; 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.