Individual provider Active NPI

Carolyn Corker-Free, PH.D.

  • Psychologist
  • Seattle, WA
National Provider Identifier
1952451148
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
1754 Issued in WA
Practice address
10740 Meridian Ave N
#110
Seattle, WA 98133-9010
Phone
(206) 361-6533
Fax
(206) 363-7622
NPI assigned
Jan 11, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 1754 WA Primary

Addresses

Primary practice location

10740 Meridian Ave N
#110
Seattle, WA 98133-9010

Mailing address

10740 Meridian Ave N
#110
Seattle, WA 98133-9010
Phone (206) 361-6533

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110221000803 WA Practitioner - Clinical Psychologist 5799974085 Practice locations: Seattle, WA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
University of Washington School of Medicine, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

1833 N 105TH St
Suite 200
Seattle, WA 98133-8973
Phone (206) 661-2055

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
1754WAMDPsychologist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1168473600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1952451148",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10740 MERIDIAN AVE N",
            "address_2": "#110",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981339010",
            "telephone_number": "206-361-6533",
            "fax_number": "206-363-7622"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10740 MERIDIAN AVE N",
            "address_2": "#110",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981339010",
            "telephone_number": "206-361-6533",
            "fax_number": "206-363-7622"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CORKER-FREE",
        "first_name": "CAROLYN",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-11",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "WA",
            "license": "1754",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Seattle, WA

Sources for this page

Verify at the official NPI Registry.