Individual provider Active NPI

Debra Patton Rood, MSW, LICSW

  • Clinical Social Worker
  • Walla Walla, WA
National Provider Identifier
1962575084
Registry record updated May 19, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LW00009152 Issued in WA
Practice address
2330 Eastgate St, North
Ste 205
Walla Walla, WA 99362-2557
Phone
(509) 301-7252
Fax
(509) 522-2330
NPI assigned
Nov 16, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 19, 2014

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 LW00009152 WA Primary

Addresses

Primary practice location

2330 Eastgate St, North
Ste 205
Walla Walla, WA 99362-2557

Mailing address

2330 Eastgate St, North
Ste 205
Walla Walla, WA 99362-3080
Phone (509) 301-7252

Other identifiers 1

IdentifierTypeStateIssuer
LW00009152OtherWALICENSE NUMBER

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
LW00009152WAMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1163635200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1400457600000",
    "number": "1962575084",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2330 EASTGATE ST, NORTH",
            "address_2": "STE 205",
            "city": "WALLA WALLA",
            "state": "WA",
            "postal_code": "993623080",
            "telephone_number": "509-301-7252",
            "fax_number": "509-522-2330"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2330 EASTGATE ST, NORTH",
            "address_2": "STE 205",
            "city": "WALLA WALLA",
            "state": "WA",
            "postal_code": "993622557",
            "telephone_number": "509-301-7252",
            "fax_number": "509-522-2330"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROOD",
        "first_name": "DEBRA",
        "middle_name": "PATTON",
        "name_prefix": "Ms.",
        "credential": "MSW, LICSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-16",
        "last_updated": "2014-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WA",
            "license": "LW00009152",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE NUMBER",
            "identifier": "LW00009152",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Walla Walla, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2014; 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.