Individual provider Active NPI

Michael Charles Weyand, MSW, LICSW, LCSW,

  • Clinical Social Worker
  • Vancouver, WA
National Provider Identifier
1871586222
Registry record updated May 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LW00007884 Issued in WA
Practice address
6926 NE Fourth Plain Blvd
Vancouver, WA 98661-7254
Phone
(609) 933-3000
Fax
(360) 993-3099
NPI assigned
Aug 31, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 6, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X CP00004960 WA
Clinical Social Worker 1041C0700X LW00007884 WA Primary

Addresses

Primary practice location

6926 NE Fourth Plain Blvd
Vancouver, WA 98661-7254

Mailing address

1601 E 4TH Plain Blvd
Vancouver, WA 98661-3753
Phone (360) 624-2744

Other identifiers 1

IdentifierTypeStateIssuer
1871586222MedicaidWA

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
I20050217000741 WA Practitioner - Clinical Social Worker 7719939784 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Columbia River Mental Health ServicesGroup PAC ID 2860385309, 14 clinicians

Practice addresses (Care Compare)

6926 NE 4TH Plain Blvd
Vancouver, WA 98661-7254
Phone (360) 993-3000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CP00004960WAMDAddiction (Substance Use Disorder) Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Columbia River Mental Health Services CurrentSince Jan 20, 2020 Accepting new patients
Macomb Family Services, Inc Addiction (Substance Use Disorder) Past Accepting new patients
Macomb Family Services, Inc. Clinical PastSince Jan 1, 1995 Accepting new patients

Locations

6926 NE Fourth Plain Blvd
Vancouver, WA 98661
Phone (360) 695-3416

Interoperability endpoints

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

Organizations & group practices 3

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": "1125446400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1746489600000",
    "number": "1871586222",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1601 E 4TH PLAIN BLVD",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986613753",
            "telephone_number": "360-624-2744"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6926 NE FOURTH PLAIN BLVD",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986617254",
            "telephone_number": "609-933-3000",
            "fax_number": "360-993-3099"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEYAND",
        "first_name": "MICHAEL",
        "middle_name": "CHARLES",
        "name_prefix": "Mr.",
        "credential": "MSW, LICSW, LCSW,",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-31",
        "last_updated": "2025-05-06",
        "certification_date": "2025-05-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "WA",
            "license": "CP00004960",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WA",
            "license": "LW00007884",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1871586222",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Vancouver, WA

Sources for this page

Verify at the official NPI Registry.