Patrick Charles Flores, LICSW, MSW, CDP

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

LW00009194 Issued in WA

Practice address

919 S 2ND Ave
Walla Walla, WA 99362-4114

Phone

(509) 529-6036

Fax

(509) 529-6038

NPI assigned

Aug 2, 2018

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1533168000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1533168000000",
    "number": "1962980896",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "919 S 2ND AVE",
            "city": "WALLA WALLA",
            "state": "WA",
            "postal_code": "993624114",
            "telephone_number": "509-529-6036",
            "fax_number": "509-529-6038"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "919 S 2ND AVE",
            "city": "WALLA WALLA",
            "state": "WA",
            "postal_code": "993624114",
            "telephone_number": "509-529-6036",
            "fax_number": "509-529-6038"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FLORES",
        "first_name": "PATRICK",
        "middle_name": "CHARLES",
        "name_prefix": "Mr.",
        "credential": "LICSW, MSW, CDP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-08-02",
        "last_updated": "2018-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WA",
            "license": "LW00009194",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Carol Ellen Flaugher-Rupe, PA-C
• Robert Dale Fleming, M.D.
• Erin Nova Fletcher, PA STUDENT
• Whitney Marie Flippo, LPN
• Katherine Elizabeth Flores, ARNP/CNM
• Reyna Flores
• Andrew Lamont Fluckiger, M.D.
• Katelinn Chelsea Foley-Hutsell, LMP
• Bayli Follett
• Elizabeth Follis

• All providers in Walla Walla, WA
• Clinical Social Worker in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 2018; 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.