Individual provider Active NPI

Carol Lee Mayes, M.S.W.

  • Clinical Social Worker
  • Seattle, WA
National Provider Identifier
1790969962
Registry record updated Aug 6, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LW00006091 Issued in WA
Practice address
4649 Sunnyside Ave N Ste 344
Seattle, WA 98103-6955
Phone
(206) 817-3036
NPI assigned
Dec 24, 2007
Last updated
Aug 6, 2009By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 6, 2009

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 LW00006091 WA Primary

Addresses

Primary practice location

4649 Sunnyside Ave N Ste 344
Seattle, WA 98103-6955

Mailing address

4649 Sunnyside Ave N Ste 344
Seattle, WA 98103-6955
Phone (206) 817-3036

Other identifiers 1

IdentifierTypeStateIssuer
G8879944OtherWAPROVIDER TRANSACTION ACCESS NUMBER (PTAN)

Other names 1

  • Carol Lee Kleiman Former name

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
I20090513000537 WA Practitioner - Clinical Social Worker 9436207248 Practice locations: Seattle, WA

Care Compare profile

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

Practice addresses (Care Compare)

4649 Sunnyside Ave N
Suite 346
Seattle, WA 98103-6900
Phone (206) 817-3036

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LW00006091WAMDClinical Social Worker
6091WAMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1198454400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1249516800000",
    "number": "1790969962",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4649 SUNNYSIDE AVE N STE 344",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981036955",
            "telephone_number": "206-817-3036"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4649 SUNNYSIDE AVE N STE 344",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981036955",
            "telephone_number": "206-817-3036"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAYES",
        "first_name": "CAROL",
        "middle_name": "LEE",
        "credential": "M.S.W.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-12-24",
        "last_updated": "2009-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WA",
            "license": "LW00006091",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PROVIDER TRANSACTION ACCESS NUMBER (PTAN)",
            "identifier": "G8879944",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CAROL",
            "last_name": "KLEIMAN",
            "middle_name": "LEE",
            "credential": "M.S.W.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Seattle, WA

Sources for this page

Verify at the official NPI Registry.