Individual provider Active NPI

Kristie Flournoy-Earnshaw, LICSW

  • Clinical Social Worker
  • Seattle, WA
National Provider Identifier
1902529449
Registry record updated Oct 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
SC61311215 Issued in WA
Practice address
11633 Rainier Ave S
Seattle, WA 98178-3945
Phone
(253) 495-5776
NPI assigned
Sep 20, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 30, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X SC61311215 WA Primary

Addresses

Primary practice location

11633 Rainier Ave S
Seattle, WA 98178-3945

Mailing address

11633 Rainier Ave S
Seattle, WA 98178-3945
Phone (253) 495-5776

Other names 1

  • Kristie Flournoy Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
SC61311215WAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Kristie Flournoy PLLC Clinical CurrentSince Sep 23, 2024 Accepting new patients

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": "1663632000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730246400000",
    "number": "1902529449",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11633 RAINIER AVE S",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981783945",
            "telephone_number": "253-495-5776"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11633 RAINIER AVE S",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981783945",
            "telephone_number": "253-495-5776"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FLOURNOY-EARNSHAW",
        "first_name": "KRISTIE",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-09-20",
        "last_updated": "2024-10-30",
        "certification_date": "2024-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WA",
            "license": "SC61311215",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KRISTIE",
            "last_name": "FLOURNOY",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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 30, 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.