Individual provider Active NPI

Linda Wackerman, MSW

  • Clinical Social Worker
  • Seattle, WA
National Provider Identifier
1770596447
Registry record updated May 17, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LW00006726 Issued in WA
Practice address
E Stevens Cir
Seattle, WA 98195-0001
Phone
(206) 616-2495
NPI assigned
Aug 14, 2006
Last updated
May 17, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 17, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X LW00006726 WA Primary

Addresses

Primary practice location

E Stevens Cir
Seattle, WA 98195-0001

Mailing address

47 Maple St
Ste 303
Burlington, VT 05401-4956
Phone (802) 861-3719

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VT
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
I20110523000197 VT Practitioner - Clinical Social Worker 4880699255 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1982
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

47 Maple St
Suite 330
Burlington, VT 05401-5097
Phone (802) 861-3719

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LW00006726WAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Association of University Physicians Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1155513600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1463443200000",
    "number": "1770596447",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "47 MAPLE ST",
            "address_2": "STE 303",
            "city": "BURLINGTON",
            "state": "VT",
            "postal_code": "054014956",
            "telephone_number": "802-861-3719",
            "fax_number": "802-861-0010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "E STEVENS CIR",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981950001",
            "telephone_number": "206-616-2495"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WACKERMAN",
        "first_name": "LINDA",
        "credential": "MSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-14",
        "last_updated": "2016-05-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WA",
            "license": "LW00006726",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Seattle, WA

Sources for this page

Verify at the official NPI Registry.