Active NPI
Heather Kazda, SW
- Clinical Social Worker
- Olympia, WA
National Provider Identifier
1770611485
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 1041C0700X
- Practice address
- 200 20TH Ave SW
Olympia, WA 98501-2808 - Phone
- (505) 264-0601
- NPI assigned
- Mar 2, 2007
- 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 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | M 5779 | NM | |
| School Social Worker | 1041S0200X | M 5779 | NM | |
| Clinical Social Worker | 1041C0700X | 1041C0700X | WA | Primary |
Addresses
Primary practice location
200 20TH Ave SW
Olympia, WA 98501-2808
Mailing address
200 20TH Ave SW
Olympia, WA 98501-2808
Phone (505) 264-0601
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 80570062 | Medicaid | NM |
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| M 5779 | NM | MD | Social Worker |
| 1041C0700X | WA | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1172793600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1466985600000",
"number": "1770611485",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "200 20TH AVE SW",
"city": "OLYMPIA",
"state": "WA",
"postal_code": "985012808",
"telephone_number": "505-264-0601"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "200 20TH AVE SW",
"city": "OLYMPIA",
"state": "WA",
"postal_code": "985012808",
"telephone_number": "505-264-0601"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KAZDA",
"first_name": "HEATHER",
"credential": "SW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-03-02",
"last_updated": "2016-06-27",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "NM",
"license": "M 5779",
"primary": false
},
{
"code": "1041S0200X",
"taxonomy_group": "",
"desc": "Social Worker, School",
"state": "NM",
"license": "M 5779",
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "WA",
"license": "1041C0700X",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "80570062",
"state": "NM"
}
],
"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 27, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.