Individual provider Active NPI

Cuyler Ann Simmons, MSW, LSWAIC, CDPT

  • Clinical Social Worker
  • Bellevue, WA
National Provider Identifier
1962912105
Registry record updated Jan 3, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
SC60879140 Issued in WA
Practice address
3805 108TH Ave NE Ste 204
Bellevue, WA 98004
Phone
(425) 242-1713
Fax
(425) 242-0587
NPI assigned
Oct 2, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 3, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X CO60877922 WA
Clinical Social Worker 1041C0700X SC60879140 WA Primary

Addresses

Primary practice location

3805 108TH Ave NE Ste 204
Bellevue, WA 98004

Mailing address

3805 108TH Ave NE Ste 204
Bellevue, WA 98004-7613
Phone (425) 242-1713

Other practice location 1

6100 Southcenter Blvd
Tukwila, WA 98188-2442
Phone (206) 444-7800

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
CO60877922WAMDAddiction (Substance Use Disorder) Counselor
SC60879140WAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Awakenings Counseling PLLC CurrentSince Jan 12, 2025 Accepting new patients
Bluestone Psychological Services, LLC Past Accepting new patients
Sound PastSince Oct 14, 2012 Accepting new patients
Ikron Greater Seattle Past Accepting new patients
Ikron Greater Seattle Past Accepting new patients

Organizations & group practices 5

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": "1506902400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1546473600000",
    "number": "1962912105",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3805 108TH AVE NE STE 204",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980047613",
            "telephone_number": "425-242-1713",
            "fax_number": "425-242-0587"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3805 108TH AVE NE STE 204",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "98004",
            "telephone_number": "425-242-1713",
            "fax_number": "425-242-0587"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6100 Southcenter Blvd",
            "address_purpose": "LOCATION",
            "city": "Tukwila",
            "state": "WA",
            "postal_code": "981882442",
            "country_code": "US",
            "telephone_number": "206-444-7800",
            "fax_number": "206-444-7810",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SIMMONS",
        "first_name": "CUYLER",
        "middle_name": "ANN",
        "name_prefix": "Ms.",
        "credential": "MSW, LSWAIC, CDPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-10-02",
        "last_updated": "2019-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "WA",
            "license": "CO60877922",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WA",
            "license": "SC60879140",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bellevue, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 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.

Verify at the official NPI Registry.