Active NPI
Kathleen M King, LICSW, LCSW
- Clinical Social Worker
- Olympia, WA
National Provider Identifier
1750615803
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- LW60938651
- Practice address
- 222 Columbia St NW
Olympia, WA 98501-8208 - Phone
- (971) 258-0851
- NPI assigned
- Sep 22, 2009
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 4334 | OR | |
| Clinical Social Worker | 1041C0700X | LW60938651 | WA | Primary |
Addresses
Primary practice location
222 Columbia St NW
Olympia, WA 98501-8208
Mailing address
PO Box 2322
Olympia, WA 98507-2322
Phone (971) 258-0851
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2129935 | Medicaid | WA |
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LW60938651 | WA | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1253577600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1593388800000",
"number": "1750615803",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 2322",
"city": "OLYMPIA",
"state": "WA",
"postal_code": "985072322",
"telephone_number": "971-258-0851"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "222 COLUMBIA ST NW",
"city": "OLYMPIA",
"state": "WA",
"postal_code": "985018208",
"telephone_number": "971-258-0851"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KING",
"first_name": "KATHLEEN",
"middle_name": "M",
"name_prefix": "Ms.",
"credential": "LICSW, LCSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2009-09-22",
"last_updated": "2020-06-29",
"certification_date": "2020-06-29",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "OR",
"license": "4334",
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "WA",
"license": "LW60938651",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "2129935",
"state": "WA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Olympia, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.