NPIMap

Organization Active NPI

Lutheran Community Services Northwest

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Seatac, WA
National Provider Identifier
1962628297
Registry record updated Oct 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
Legal business name
LUTHERAN COMMUNITY SERVICES NORTHWEST
Practice address
4040 S 188TH St Ste 300
Seatac, WA 98188-5070
Phone
(206) 816-3253
Fax
(206) 838-2680
NPI assigned
Apr 17, 2007
Last updated
Oct 13, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 13, 2026

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

Authorized official

Name
Shelia Clark
Title
Qa&I Manager
Phone
(541) 201-3973

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X CERTIFICATE136 WA
Clinical Social Worker 1041C0700X CERTIFICATE136 WA
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X NU Primary

Addresses

Primary practice location

4040 S 188TH St Ste 300
Seatac, WA 98188-5070

Mailing address

4040 S 188TH St Ste 300
Seatac, WA 98188-5070
Phone (206) 816-3253

Other practice location 1

916 16th St NW
Auburn, WA 98002
Phone (253) 201-3681

Other practice location 2

9725 3rd Ave NE Ste 405
Seattle, WA 98115-2024
Phone (206) 694-5700

Other practice location 3

2500 Hewitt Ave Ste 300
Everett, WA 98201-3789
Phone (425) 355-6005

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050408000542 WA Part B Supplier - Clinic/Group Practice 1254237522 Receives reassigned benefits from 21 practitioners
3 other NPIs on this enrollment
Practice locations: Spokane, WA; Seatac, WA; Kennewick, WA

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 3

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Lutheran Community SVCS NW17 organizations share this tax ID, including this one

Other organizations with this tax ID 16

Organizations that report the same tax identification number in the National Provider Directory.

View all 16

Locations

2500 Hewitt Ave
Ste 300
Everett, WA 98201
Phone (206) 694-5700

10803 SE Kent Kangley Rd
Ste 101
Kent, WA 98030
Phone (253) 487-7573

433 Minor Ave N
Seattle, WA 98109
Phone (206) 694-5740

Practitioners & affiliated clinicians

Practitioners 47

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 47

NPI Registry JSON

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

{
    "created_epoch": "1176768000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1791849600000",
    "number": "1962628297",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4040 S 188TH ST STE 300",
            "city": "SEATAC",
            "state": "WA",
            "postal_code": "981885070",
            "telephone_number": "206-816-3253",
            "fax_number": "206-838-2680"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4040 S 188TH ST STE 300",
            "city": "SEATAC",
            "state": "WA",
            "postal_code": "981885070",
            "telephone_number": "206-816-3253",
            "fax_number": "206-838-2680"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "916 16th St NW",
            "address_purpose": "LOCATION",
            "city": "Auburn",
            "state": "WA",
            "postal_code": "98002",
            "country_code": "US",
            "telephone_number": "253-201-3681",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "9725 3rd Ave NE Ste 405",
            "address_purpose": "LOCATION",
            "city": "Seattle",
            "state": "WA",
            "postal_code": "981152024",
            "country_code": "US",
            "telephone_number": "206-694-5700",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2500 Hewitt Ave Ste 300",
            "address_purpose": "LOCATION",
            "city": "Everett",
            "state": "WA",
            "postal_code": "982013789",
            "country_code": "US",
            "telephone_number": "425-355-6005",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "LUTHERAN COMMUNITY SERVICES NORTHWEST",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-17",
        "last_updated": "2026-10-13",
        "certification_date": "2026-10-09",
        "status": "A",
        "authorized_official_last_name": "CLARK",
        "authorized_official_first_name": "SHELIA",
        "authorized_official_title_or_position": "QA&I MANAGER",
        "authorized_official_telephone_number": "541-201-3973"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WA",
            "license": "CERTIFICATE136",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WA",
            "license": "CERTIFICATE136",
            "primary": false
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Seatac, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.