Daniel Clemons, LCSW

Individual provider Active NPI Clinical Social Worker · Port Townsend, WA

NPI 1821474073 · NPPES record last updated Jul 15, 2021

Key facts

NPI
1821474073
Entity type
Individual (NPI type 1)
Primary specialty
Clinical Social Worker 1041C0700X
License
703 (KY)
Practice address
884 W Park Ave
Port Townsend, WA 98368-2273
Phone
(360) 385-0321
Fax
(360) 379-5534
NPI assigned
Aug 10, 2015
Sex
Male
Sole proprietor
No

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.

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
703KYMDAddiction (Substance Use Disorder) Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Jefferson Community Counseling Center Current
since Jul 25, 2021
Accepting new patients
Madrona Institute of Washington Past
since Jul 25, 2021
Accepting new patients

Locations

884 W Park Ave
Port Townsend, WA 98368
Phone 3603850321201

Interoperability endpoints

  • FHIR API: https://api.qualifacts.org/api/fhir/discoverybh/r4/

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 703 KY Yes

Addresses

Primary practice location

884 W Park Ave
Port Townsend, WA 98368-2273

Mailing address

104 S Front Ave
Prestonsburg, KY 41653-1614
Phone (606) 886-8572

Other practice location 1

104 S Front Ave
Prestonsburg, KY 41653-1614
Phone (606) 886-8572

Other providers in Port Townsend, WA

All providers in Port Townsend, WA · Clinical Social Worker in Washington

Sources for this page

Verify at the official NPI Registry.