Individual provider Active NPI

Anastacia Sergeyivna Kakorin

  • Clinical Social Worker
  • Everett, WA
National Provider Identifier
1780593764
Registry record updated Sep 4, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
SWIA.SC.70133350 Issued in WA
Practice address
811 Madison St
Everett, WA 98203-4543
Phone
(425) 212-4200
Fax
(425) 212-4201
NPI assigned
Sep 4, 2026
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 4, 2026

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 SWIA.SC.70133350 WA Primary

Addresses

Primary practice location

811 Madison St
Everett, WA 98203-4543

Mailing address

PO Box 2569
Everett, WA 98213-0569
Phone (425) 212-4200

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

NPI Registry JSON

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

{
    "created_epoch": "1788480000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788480000000",
    "number": "1780593764",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2569",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982130569",
            "telephone_number": "425-212-4200",
            "fax_number": "425-212-4201"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "811 MADISON ST",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982034543",
            "telephone_number": "425-212-4200",
            "fax_number": "425-212-4201"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAKORIN",
        "first_name": "ANASTACIA",
        "middle_name": "SERGEYIVNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-09-04",
        "last_updated": "2026-09-04",
        "certification_date": "2026-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WA",
            "license": "SWIA.SC.70133350",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Everett, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.

Verify at the official NPI Registry.