Individual provider Active NPI

Justin Evan Lerner, PHD, LICSW

  • Clinical Social Worker
  • Seattle, WA
National Provider Identifier
1790336956
Registry record updated Sep 27, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LW60960616 Issued in WA
Practice address
338 NW 85TH St
Seattle, WA 98117-3120
Phone
(206) 659-5945
NPI assigned
Sep 27, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 27, 2019

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 LW60960616 WA Primary

Addresses

Primary practice location

338 NW 85TH St
Seattle, WA 98117-3120

Mailing address

4101 15TH Ave NE
Seattle, WA 98105-6250
Phone (206) 685-2910

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
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
LW60960616WAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Seattle Therapy Practice, PLLC Clinical CurrentSince Nov 13, 2022 Accepting new patients
Bob'S Psychotherapy CurrentSince Oct 13, 2024 Accepting new patients

Locations

338 NW 85th St
Seattle, WA 98117
Phone (206) 659-5945

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1569542400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1569542400000",
    "number": "1790336956",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4101 15TH AVE NE",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981056250",
            "telephone_number": "206-685-2910"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "338 NW 85TH ST",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981173120",
            "telephone_number": "206-659-5945"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LERNER",
        "first_name": "JUSTIN",
        "middle_name": "EVAN",
        "name_prefix": "Dr.",
        "credential": "PHD, LICSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-09-27",
        "last_updated": "2019-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WA",
            "license": "LW60960616",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Seattle, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.