Individual provider Active NPI

Renee Vaughn-Beaulieu

  • Clinical Social Worker
  • Vancouver, WA
National Provider Identifier
1730732843
Registry record updated Mar 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LW61343252 Issued in WA
Practice address
3200 NE 109TH Ave
Vancouver, WA 98682-7749
Phone
(360) 695-1014
NPI assigned
Jul 17, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 3, 2025

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 LW61343252 WA
Clinical Social Worker 1041C0700X LW61343252 WA Primary

Addresses

Primary practice location

3200 NE 109TH Ave
Vancouver, WA 98682-7749

Mailing address

3200 NE 109TH Ave
Vancouver, WA 98682-7749
Phone (360) 695-1014

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20250304002365 WA Practitioner - Clinical Social Worker 6002337284 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
The Vancouver Clinic Inc PSGroup PAC ID 3173436490, 580 clinicians

Practice addresses (Care Compare)

7809 NE Vancouver Plaza Dr
Suite 110
Vancouver, WA 98662-6639
Phone (360) 882-2778

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LW61343252WAMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
The Vancouver Clinic Inc PS CurrentSince Apr 8, 2025 Accepting new patients
The Vancouver Clinic Inc PS CurrentSince Apr 8, 2025 Accepting new patients
The Vancouver Clinic Inc PS Current Accepting new patients
Family Solutions, Inc CurrentSince Jul 25, 2019 Accepting new patients

Locations

700 NE 87th Ave
Vancouver, WA 98664
Phone (360) 397-1500

3200 NE 109th Ave
Vancouver, WA 98682
Phone (360) 695-1014

7809 NE Vancouver Plaza Dr
Ste 110
Vancouver, WA 98662

1014 Main St
Vancouver, WA 98660
Phone (360) 695-1014

Interoperability endpoints

  • FHIR API: https://api.qualifacts.org/api/fhir/family-solutions/r4/

Organizations & group practices 4

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": "1563321600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740960000000",
    "number": "1730732843",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3200 NE 109TH AVE",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986827749",
            "telephone_number": "360-695-1014",
            "fax_number": "360-750-1374"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3200 NE 109TH AVE",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986827749",
            "telephone_number": "360-695-1014"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAUGHN-BEAULIEU",
        "first_name": "RENEE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-07-17",
        "last_updated": "2025-03-03",
        "certification_date": "2025-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "WA",
            "license": "LW61343252",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WA",
            "license": "LW61343252",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vancouver, WA

Sources for this page

Verify at the official NPI Registry.