Active NPI
Martha Lee Reynolds, M.S.W., L.I.C.S.W.
- Clinical Social Worker
- Seattle, WA
National Provider Identifier
1871745109
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 00009623
- Practice address
- 318 W Galer St Ste 204
Seattle, WA 98119-3370 - Phone
- (206) 284-6511
- NPI assigned
- Oct 17, 2008
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 00009623 | WA | Primary |
Addresses
Primary practice location
318 W Galer St Ste 204
Seattle, WA 98119-3370
Mailing address
318 W Galer St Ste 204
Seattle, WA 98119-3370
Phone (206) 284-6511
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Apr 22, 2023 through Apr 22, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 00009623 | WA | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1224201600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1224201600000",
"number": "1871745109",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "318 W GALER ST STE 204",
"city": "SEATTLE",
"state": "WA",
"postal_code": "981193370",
"telephone_number": "206-284-6511"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "318 W GALER ST STE 204",
"city": "SEATTLE",
"state": "WA",
"postal_code": "981193370",
"telephone_number": "206-284-6511"
}
],
"practiceLocations": [],
"basic": {
"last_name": "REYNOLDS",
"first_name": "MARTHA",
"middle_name": "LEE",
"name_prefix": "Ms.",
"credential": "M.S.W., L.I.C.S.W.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-10-17",
"last_updated": "2008-10-17",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "WA",
"license": "00009623",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Seattle, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.