Individual provider Active NPI

Jessica A De Larwelle, MSW

  • Social Worker
  • Everett, WA
National Provider Identifier
1811566409
Registry record updated Feb 25, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
LW60877309 Issued in WA
Practice address
2930 Maple St
Everett, WA 98201-3832
Phone
(425) 261-1500
Fax
(425) 261-1515
NPI assigned
Jun 18, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 25, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 8707-123 WI
Social Worker 104100000X LW60877309 WA Primary

Addresses

Primary practice location

2930 Maple St
Everett, WA 98201-3832

Mailing address

2930 Maple St
Everett, WA 98201-3832
Phone (425) 261-1500

Other identifiers 1

IdentifierTypeStateIssuer
UNKNOWNMedicaidWA

Electronic endpoints 2

TypeEndpointUseAffiliation
Other URL Jessica.delarwelle@gmail.com Other
SOAP URL https://careepicwa.kp.org:14430/Interconnect-CE-PRD/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ceq Health Information Exchange (HIE)

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
I20221008000124 WA Practitioner - Clinical Social Worker 9739565102 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Kaiser Foundation Health Plan of WashingtonGroup PAC ID 9032022579, 1,519 clinicians

Practice addresses (Care Compare)

2930 Maple St
Everett, WA 98201-3832
Phone (425) 261-1500

Merit-based Incentive Payment System (MIPS)

Final score
84.22 of 100Reported as group
Quality
72.08
Promoting interoperability
70
Improvement activities
40
Cost
66.98

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
8707-123WIMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Kaiser Foundation Health Plan of Washington CurrentSince Sep 26, 2022 Accepting new patients
Kaiser Foundation Health Plan of Washington CurrentSince Sep 26, 2022 Accepting new patients
Kaiser Foundation Health Plan of Washington Current Accepting new patients
Responsive Therapy & Consulting PLLC Current Accepting new patients

Locations

2930 Maple St
Everett, WA 98201
Phone (425) 261-1500

200 15th Ave E
Seattle, WA 98112
Phone (206) 326-4530

9505 S Steele St
Tacoma, WA 98444
Phone (253) 597-6800

Interoperability endpoints

  • Direct secure messaging: jdelarwelle4179005@ghc.direct-ci.net

Organizations & group practices 4

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": "1623974400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677283200000",
    "number": "1811566409",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2930 MAPLE ST",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982013832",
            "telephone_number": "425-261-1500",
            "fax_number": "425-261-1515"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2930 MAPLE ST",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982013832",
            "telephone_number": "425-261-1500",
            "fax_number": "425-261-1515"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DE LARWELLE",
        "first_name": "JESSICA",
        "middle_name": "A",
        "credential": "MSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-06-18",
        "last_updated": "2023-02-25",
        "certification_date": "2023-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WI",
            "license": "8707-123",
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "WA",
            "license": "LW60877309",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "UNKNOWN",
            "state": "WA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "Jessica.delarwelle@gmail.com",
            "affiliation": "N",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "Email",
            "address_1": "2900 Grand Ave Apt 539",
            "city": "Everett",
            "state": "WA",
            "country_code": "US",
            "postal_code": "982014896",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwa.kp.org:14430/Interconnect-CE-PRD/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ceq",
            "affiliation": "N",
            "endpointDescription": "Carequality",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "2930 Maple St",
            "city": "Everett",
            "state": "WA",
            "country_code": "US",
            "postal_code": "982013832",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Everett, WA

Sources for this page

Verify at the official NPI Registry.