Active NPI
Carol Gilliom
- Clinical Social Worker
- Ellensburg, WA
National Provider Identifier
1881764769
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- LW00004092
- Practice address
- 220 W 4TH Ave
Ellensburg, WA 98926-3060 - Phone
- (509) 925-9861
- NPI assigned
- Nov 8, 2006
- Last updated
- Mar 22, 2011
- Sex
- Female
- Sole proprietor
- No
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 | LW00004092 | WA | Primary |
Addresses
Primary practice location
220 W 4TH Ave
Ellensburg, WA 98926-3060
Mailing address
PO Box 959
Yakima, WA 98907-0959
Phone (509) 575-4084
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Social Worker
- Education
- Other, 1993
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
2109 W Dolarway Rd
Ellensburg, WA 98926-9367
Phone (509) 968-5086
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Valley Psychological Services | Current | Accepting new patients |
Locations
2109 W Dolarway Rd
Ellensburg, WA 98926
Phone (509) 968-5086
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Psychologist
- Ellensburg, WA
- NPI 1356842785
-
- Community/Behavioral Health Agency
- Yakima, WA
- NPI 1073527453
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1162944000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1300752000000",
"number": "1881764769",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 959",
"city": "YAKIMA",
"state": "WA",
"postal_code": "989070959",
"telephone_number": "509-575-4084"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "220 W 4TH AVE",
"city": "ELLENSBURG",
"state": "WA",
"postal_code": "989263060",
"telephone_number": "509-925-9861"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GILLIOM",
"first_name": "CAROL",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-11-08",
"last_updated": "2011-03-22",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "WA",
"license": "LW00004092",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Ellensburg, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.