Individual provider Active NPI

David Lee Taub

  • Clinical Social Worker
  • Vancouver, WA
National Provider Identifier
1942709134
Registry record updated Jan 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
61191404 Issued in WA
Practice address
7700 NE 26TH Ave
Vancouver, WA 98665-0672
Phone
(360) 397-8228
Fax
(360) 353-9440
NPI assigned
Feb 2, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 6, 2025

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 61191404 WA Primary

Addresses

Primary practice location

7700 NE 26TH Ave
Vancouver, WA 98665-0672

Mailing address

PO Box 2429
Longview, WA 98632-8486
Phone (360) 353-9494

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20250225000455 TX Practitioner - Clinical Social Worker 4587184312 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
61191404WAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
X Change Recovery Mental Health CurrentSince Jul 5, 2020 Accepting new patients
Cowlitz Indian Tribe CurrentSince Dec 17, 2024 Accepting new patients
Cowlitz Indian Tribe CurrentSince Dec 17, 2024 Accepting new patients
Xchange Behavioral Health Agency CurrentSince Jun 12, 2022 Accepting new patients
Cowlitz Indian Tribe Past Accepting new patients
Cowlitz Indian Tribe Past Accepting new patients
Cowlitz Indian Tribe Past Accepting new patients
Cowlitz Indian Tribe Past Accepting new patients

Locations

1044 11th Ave
Longview, WA 98632
Phone (360) 575-3314

900 Fir St
Longview, WA 98632
Phone (360) 353-9422

21810 NE 37th Ave
Ridgefield, WA 98642
Phone (844) 777-9242

7700 NE 26th Ave
Vancouver, WA 98665
Phone (360) 397-8228

Organizations & group practices 8

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": "1517529600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736121600000",
    "number": "1942709134",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2429",
            "city": "LONGVIEW",
            "state": "WA",
            "postal_code": "986328486",
            "telephone_number": "360-353-9494",
            "fax_number": "360-353-9440"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7700 NE 26TH AVE",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986650672",
            "telephone_number": "360-397-8228",
            "fax_number": "360-353-9440"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAUB",
        "first_name": "DAVID",
        "middle_name": "LEE",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-02-02",
        "last_updated": "2025-01-06",
        "certification_date": "2025-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WA",
            "license": "61191404",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vancouver, WA

Sources for this page

Verify at the official NPI Registry.