Individual provider Active NPI

Natasha Anne Rustad, LICSW, LCSW

  • Clinical Social Worker
  • College Place, WA
National Provider Identifier
1871676445
Registry record updated Jul 5, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LW 60118602 Issued in WA
Practice address
56 N College Ave Unit 2
College Place, WA 99324-4069
Phone
(509) 730-9894
Fax
(844) 512-2575
NPI assigned
Oct 24, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 5, 2023

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 L5028 OR
Clinical Social Worker 1041C0700X LW 60118602 WA Primary

Addresses

Primary practice location

56 N College Ave Unit 2
College Place, WA 99324-4069

Mailing address

PO Box 3192
Walla Walla, WA 99362-0366
Phone (541) 708-1979

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
I20150507001973 WA Practitioner - Clinical Social Worker 6800054917 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

56 N College Ave
Unit 2
College Place, WA 99324-1048
Phone (509) 730-9894

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
L5028ORMDClinical Social Worker
LW 60118602WAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Rustad Counseling, LLC CurrentSince Sep 5, 2023 Accepting new patients

Locations

56 N College Ave
Unit 2
College Place, WA 99324
Phone (509) 301-2426

Organizations & group practices 1

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": "1161648000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688515200000",
    "number": "1871676445",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3192",
            "city": "WALLA WALLA",
            "state": "WA",
            "postal_code": "993620366",
            "telephone_number": "541-708-1979"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "56 N COLLEGE AVE UNIT 2",
            "city": "COLLEGE PLACE",
            "state": "WA",
            "postal_code": "993244069",
            "telephone_number": "509-730-9894",
            "fax_number": "844-512-2575"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSTAD",
        "first_name": "NATASHA",
        "middle_name": "ANNE",
        "credential": "LICSW, LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-24",
        "last_updated": "2023-07-05",
        "certification_date": "2023-07-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OR",
            "license": "L5028",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WA",
            "license": "LW 60118602",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in College Place, WA

Sources for this page

Verify at the official NPI Registry.