Individual provider Active NPI

Susan K. Jenkins, PH.D.

  • Clinical Social Worker
  • Seattle, WA
National Provider Identifier
1770639916
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LW00004005 Issued in WA
Practice address
320 W Galer St
Seattle, WA 98119-3334
Phone
(206) 285-7215
NPI assigned
Jan 27, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 LW00004005 WA Primary

Addresses

Primary practice location

320 W Galer St
Seattle, WA 98119-3334

Mailing address

320 W Galer St
Seattle, WA 98119-3334
Phone (206) 285-7215

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
I20050107000489 WA Practitioner - Clinical Social Worker 0244288082 Practice locations: Seattle, WA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1980
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2812 E Madison St
Suite 3
Seattle, WA 98112-4863
Phone (206) 285-7215

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
LW00004005WAMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1169856000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1770639916",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "320 W GALER ST",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981193334",
            "telephone_number": "206-285-7215"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "320 W GALER ST",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981193334",
            "telephone_number": "206-285-7215"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JENKINS",
        "first_name": "SUSAN",
        "middle_name": "K.",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-27",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WA",
            "license": "LW00004005",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Seattle, WA

Sources for this page

Verify at the official NPI Registry.