Kodie Jo Mobbs, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

LW61333990 Issued in WA

Practice address

23801 E Appleway Ave Ste 110
Liberty Lake, WA 99019-9687

Phone

(509) 386-2888

NPI assigned

Sep 28, 2017

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Other names 1

• Kodie Jo Shubert Former name

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1506556800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665964800000",
    "number": "1841709243",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13799 N MATHESON RD",
            "city": "HAUSER",
            "state": "ID",
            "postal_code": "838545599",
            "telephone_number": "509-386-2888"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23801 E APPLEWAY AVE STE 110",
            "city": "LIBERTY LAKE",
            "state": "WA",
            "postal_code": "990199687",
            "telephone_number": "509-386-2888"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "13799 N Matheson Rd",
            "address_purpose": "LOCATION",
            "city": "Hauser",
            "state": "ID",
            "postal_code": "83854",
            "country_code": "US",
            "telephone_number": "509-386-2888",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOBBS",
        "first_name": "KODIE",
        "middle_name": "JO",
        "credential": "LICSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-09-28",
        "last_updated": "2022-10-17",
        "certification_date": "2022-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WA",
            "license": "SC60903029",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WA",
            "license": "LW61333990",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "info@whisperingwindstherapy.com",
            "affiliation": "N",
            "endpointDescription": "email",
            "address_1": "23801 E Appleway Ave Ste 110",
            "city": "Liberty Lake",
            "state": "WA",
            "country_code": "US",
            "postal_code": "990199687",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "KODIE",
            "last_name": "SHUBERT",
            "middle_name": "JO",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Clarence Harold Mielke, M.D.
• Jessica Leann Miles, M ED. LCPC
• Rikki Jayne Miller, MS, LMHC
• Keenan Anthony Milonas, MD
• Sully Moon, IP
• Nicole Jean Mulligan, RPH
• Multicare Health System (Multicare Rockwood Liberty Lake)
• Jolynn S Munro, OTR
• Susan J Naccarato, DC

• Clinical Social Worker in Liberty Lake, WA
• Providers in Liberty Lake, WA by specialty
• Clinical Social Worker in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2022; 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.