Individual provider Active NPI

Sheba Summers

  • Social Worker
  • Bremerton, WA
National Provider Identifier
1699325944
Registry record updated Jan 21, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
SC60993748 Issued in WA
Practice address
5112 NW Taylor Rd
Bremerton, WA 98312-8837
Phone
(360) 373-2536
Fax
(360) 373-4934
NPI assigned
Sep 18, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 21, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X SC60993748 WA Primary
Counselor 101Y00000X

Addresses

Primary practice location

5112 NW Taylor Rd
Bremerton, WA 98312-8837

Mailing address

5112 NW Taylor Rd
Bremerton, WA 98312-8837
Phone (360) 373-2536

Other practice location 1

7610 40th St W Ste 300
University Place, WA 98466-3834
Phone (253) 830-6242

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
SC60993748WAMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Holly Ridge Center Social Worker PastSince Jan 24, 2021 Accepting new patients

Organizations & group practices 1

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": "1568764800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611187200000",
    "number": "1699325944",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5112 NW TAYLOR RD",
            "city": "BREMERTON",
            "state": "WA",
            "postal_code": "983128837",
            "telephone_number": "360-373-2536",
            "fax_number": "360-373-4934"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5112 NW TAYLOR RD",
            "city": "BREMERTON",
            "state": "WA",
            "postal_code": "983128837",
            "telephone_number": "360-373-2536",
            "fax_number": "360-373-4934"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7610 40th St W Ste 300",
            "address_purpose": "LOCATION",
            "city": "University Place",
            "state": "WA",
            "postal_code": "984663834",
            "country_code": "US",
            "telephone_number": "253-830-6242",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SUMMERS",
        "first_name": "SHEBA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-09-18",
        "last_updated": "2021-01-21",
        "certification_date": "2021-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "WA",
            "license": "SC60993748",
            "primary": true
        },
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bremerton, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 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.