Active NPI
Bridget Ideker, LICSW
- Clinical Social Worker
- Tacoma, WA
National Provider Identifier
1932763133
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- LW60905465
- Practice address
- 6316 S 12TH St
Tacoma, WA 98465-1900 - Phone
- (235) 565-4887
- Fax
- (253) 565-2983
- NPI assigned
- Apr 24, 2019
- 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 | LW60905465 | WA | Primary |
Addresses
Primary practice location
6316 S 12TH St
Tacoma, WA 98465-1900
Mailing address
6424 N 9TH St
Tacoma, WA 98406-2091
Phone (253) 565-4484
Other practice location 1
6424 N 9th St
Tacoma, WA 98406-2091
Phone (253) 565-4484
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | lenz@hopesparks.org |
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
| License | State | Type | Specialty |
|---|---|---|---|
| LW60905465 | WA | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Hopesparks | Clinical | Past | 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": "1556064000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1556064000000",
"number": "1932763133",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6424 N 9TH ST",
"city": "TACOMA",
"state": "WA",
"postal_code": "984062091",
"telephone_number": "253-565-4484",
"fax_number": "253-565-5823"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6316 S 12TH ST",
"city": "TACOMA",
"state": "WA",
"postal_code": "984651900",
"telephone_number": "235-565-4887",
"fax_number": "253-565-2983"
}
],
"practiceLocations": [
{
"address_1": "6424 N 9th St",
"address_purpose": "LOCATION",
"city": "Tacoma",
"state": "WA",
"postal_code": "984062091",
"country_code": "US",
"telephone_number": "253-565-4484",
"fax_number": "253-565-5823",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "IDEKER",
"first_name": "BRIDGET",
"credential": "LICSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2019-04-24",
"last_updated": "2019-04-24",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "WA",
"license": "LW60905465",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "lenz@hopesparks.org",
"affiliation": "N",
"address_1": "6424 N 9th St",
"city": "Tacoma",
"state": "WA",
"country_code": "US",
"postal_code": "984062091",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Tacoma, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.