Individual provider Active NPI

Tanya Elaine Stephenson, LICSW, SUDP

  • Clinical Social Worker
  • Auburn, WA
National Provider Identifier
1861884470
Registry record updated Sep 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LW61147514 Issued in WA
Practice address
4238 Auburn Way N
Auburn, WA 98002-1311
Phone
(206) 901-2000
NPI assigned
Feb 19, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 25, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X LW61147514 WA Primary
Addiction (Substance Use Disorder) Counselor 101YA0400X CP60098046 WA

Addresses

Primary practice location

4238 Auburn Way N
Auburn, WA 98002-1311

Mailing address

19620 96TH St E
Bonney Lake, WA 98391-8441

Other practice location 1

6400 Southcenter Blvd
Tukwila, WA 98188-2547
Phone (206) 901-2000

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
I20220105002804 WA Practitioner - Clinical Social Worker 3870984677 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CP60098046WAMDAddiction (Substance Use Disorder) Counselor
LW61147514WAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Sound CurrentSince Sep 8, 2025 Accepting new patients
Prosperity Counseling & Treatment SVCS PastSince May 14, 2023 Accepting new patients

Locations

4238 Auburn Way N
Auburn, WA 98002
Phone (253) 444-0106

4240 Auburn Way N
Auburn, WA 98002
Phone (253) 876-8900

1600 E Olive St
Seattle, WA 98122
Phone (206) 302-2800

6400 Southcenter Blvd
Tukwila, WA 98188
Phone (206) 444-3600

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": "1424304000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1758758400000",
    "number": "1861884470",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19620 96TH ST E",
            "city": "BONNEY LAKE",
            "state": "WA",
            "postal_code": "983918441"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4238 AUBURN WAY N",
            "city": "AUBURN",
            "state": "WA",
            "postal_code": "980021311",
            "telephone_number": "206-901-2000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6400 Southcenter Blvd",
            "address_purpose": "LOCATION",
            "city": "Tukwila",
            "state": "WA",
            "postal_code": "981882547",
            "country_code": "US",
            "telephone_number": "206-901-2000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STEPHENSON",
        "first_name": "TANYA",
        "middle_name": "ELAINE",
        "name_prefix": "Mrs.",
        "credential": "LICSW, SUDP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-02-19",
        "last_updated": "2025-09-25",
        "certification_date": "2025-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WA",
            "license": "LW61147514",
            "primary": true
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "WA",
            "license": "CP60098046",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Auburn, WA

Sources for this page

Verify at the official NPI Registry.