Justin P Ibrahim, LICSW, MSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

LW61533180 Issued in WA

Practice address

7216 S Ryan St
Seattle, WA 98178-2618

Phone

(425) 477-9777

NPI assigned

Jun 8, 2018

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Electronic endpoints 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Community Psychiatric Clinic Inc

  • Community/Behavioral Health Agency
  • Seattle, WA
  • NPI 1629120159
  NPD (past)
• Muckleshoot Behavioral Health

  • Community/Behavioral Health Agency
  • Auburn, WA
  • NPI 1669826533
  NPD (past)

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

{
    "created_epoch": "1528416000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721779200000",
    "number": "1861985418",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2501 SW TRENTON ST # 1011",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981063206",
            "telephone_number": "425-477-9777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7216 S RYAN ST",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981782618",
            "telephone_number": "425-477-9777"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5602 California Ave SW",
            "address_purpose": "LOCATION",
            "city": "Seattle",
            "state": "WA",
            "postal_code": "981361515",
            "country_code": "US",
            "telephone_number": "206-858-8169",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "IBRAHIM",
        "first_name": "JUSTIN",
        "middle_name": "P",
        "credential": "LICSW, MSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-06-08",
        "last_updated": "2024-07-24",
        "certification_date": "2024-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "WA",
            "license": "SC61172478",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WA",
            "license": "LW61533180",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "justin@attunedrelationships.com",
            "affiliation": "N",
            "endpointDescription": "Therapeutic Counseling Office Comms",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "5602 California Ave SW",
            "city": "Seattle",
            "state": "WA",
            "country_code": "US",
            "postal_code": "981361515",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jibrahim@ibrahimgroup.org",
            "affiliation": "N",
            "endpointDescription": "Therapeutic Counseling Office Comms",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "7216 S Ryan St",
            "city": "Seattle",
            "state": "WA",
            "country_code": "US",
            "postal_code": "981782618",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Anisa Mohamed Ibrahim
• David Albeer Ibrahim, MD
• Hawi K Ibrahim, RN
• Hoda Ibrahim, PHARMD
• Jawahir Hussein Ibrahim
• Mahmoud Motaz Mohammed Ibrahim, M.D, MSC
• Megar Kamel Ibrahim
• Michelle Samir Ibrahim
• Rahma Salat Ibrahim
• Ahmed A. Ibrahimi, RRT

• Clinical Social Worker in Seattle, WA
• Providers in Seattle, 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 Jul 24, 2024; 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.