Active NPI
Steve Clancy, PH.D.
- Psychologist
- Everett, WA
National Provider Identifier
1972612687
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 1238
- Practice address
- 1604 Hewitt Ave 615
Everett, WA 98201-3536 - Phone
- (425) 770-2721
- NPI assigned
- Aug 29, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | 1238 | WA | Primary |
Addresses
Primary practice location
1604 Hewitt Ave 615
Everett, WA 98201-3536
Mailing address
10758 3Rd Ave NW
Seattle, WA 98177-4812
Phone (206) 363-6553
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 52412 | Medicaid | WA |
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)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1238 | WA | MD | Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156809600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1436832000000",
"number": "1972612687",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10758 3RD AVE NW",
"city": "SEATTLE",
"state": "WA",
"postal_code": "981774812",
"telephone_number": "206-363-6553"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1604 HEWITT AVE 615",
"city": "EVERETT",
"state": "WA",
"postal_code": "982013536",
"telephone_number": "425-770-2721"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CLANCY",
"first_name": "STEVE",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-08-29",
"last_updated": "2015-07-14",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "WA",
"license": "1238",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "52412",
"state": "WA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Everett, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.