Stephanie Mara Wichmann, MSW, LCSW/LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

LW60188224 Issued in WA

Practice address

951 Officers Row
Vancouver, WA 98661-3849

Phone

(360) 838-3356

Fax

(360) 326-1877

NPI assigned

May 12, 2016

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in OR

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

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.

• Native American Rehabilitation Assoc Inc

  • Federally Qualified Health Center (FQHC)
  • Portland, OR
  • NPI 1396734364
  Medicare reassignment NPD
• Riverway Counseling

  • Adult Mental Health Clinic/Center
  • Vancouver, WA
  • NPI 1669036174
  NPD Authorized official
• Native American Rehabilitation Assoc Inc

  • Federally Qualified Health Center (FQHC)
  • Portland, OR
  • NPI 1174979934
  NPD
• Native American Rehabilitation Assoc Inc

  • Federally Qualified Health Center (FQHC)
  • Gresham, OR
  • NPI 1942747761
  NPD

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

{
    "created_epoch": "1463011200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734912000000",
    "number": "1740636364",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "951 OFFICERS ROW",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986613849",
            "telephone_number": "360-838-3356",
            "fax_number": "360-326-1877"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "951 OFFICERS ROW",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986613849",
            "telephone_number": "360-838-3356",
            "fax_number": "360-326-1877"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1438 SE Division St",
            "address_purpose": "LOCATION",
            "city": "Portland",
            "state": "OR",
            "postal_code": "972021140",
            "country_code": "US",
            "telephone_number": "503-548-0346",
            "fax_number": "503-232-5959",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WICHMANN",
        "first_name": "STEPHANIE",
        "middle_name": "MARA",
        "name_prefix": "Ms.",
        "credential": "MSW, LCSW/LICSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-05-12",
        "last_updated": "2024-12-23",
        "certification_date": "2024-12-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OR",
            "license": "L13225",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WA",
            "license": "LW60188224",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500814577",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Landon Whittington, MD
• Elizabeth Kathleen Whitwam
• Ryan Whitworth
• Wholestic Living
• Narnia Wiborg
• Iva Wick, LMHC
• Emily Wickert
• Dennis James Wickham, M.D.
• Shelby G Wickhorst, O.D.
• Jodi Lynn Wicks

• Clinical Social Worker in Vancouver, WA
• Providers in Vancouver, 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 Dec 23, 2024; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.