Trista Nicole Mortensen, MSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

LW60004175 Issued in WA

Practice address

304 Main Ave S
Ste 102
Renton, WA 98057-2758

Phone

(206) 697-3281

Fax

(206) 358-5753

NPI assigned

Jan 31, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in WA

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

Specialty

Clinical Social Worker

Education

Other, 1999

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Freed Spirit Studios

  • Mental Health Counselor
  • Renton, WA
  • NPI 1508377805
  NPD

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

{
    "created_epoch": "1170201600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1633046400000",
    "number": "1720125636",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "304 MAIN AVE S",
            "address_2": "STE 102",
            "city": "RENTON",
            "state": "WA",
            "postal_code": "980572758",
            "telephone_number": "206-697-3281",
            "fax_number": "206-358-5753"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "304 MAIN AVE S",
            "address_2": "STE 102",
            "city": "RENTON",
            "state": "WA",
            "postal_code": "980572758",
            "telephone_number": "206-697-3281",
            "fax_number": "206-358-5753"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORTENSEN",
        "first_name": "TRISTA",
        "middle_name": "NICOLE",
        "credential": "MSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-31",
        "last_updated": "2021-10-01",
        "certification_date": "2021-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WA",
            "license": "LW60004175",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2076299",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Hilary Morland Boser
• Claudia S. Moroney, PA-C
• Malcolm Thomas Morris, RPH
• Scott D Morris, M.D.
• Beverly A. Morrow, RPH, BS, PHARM D
• Glynnis M Morton, MD
• Mei Lillian Morton, PT
• Trenton Matthew Morton, M.D.
• Ashanti Renee Mosby, LMP
• Emily Anne Moser, M.ED.

• Clinical Social Worker in Renton, WA
• Providers in Renton, 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 Oct 1, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.