Individual provider Active NPI

Teryn Michelle Sahagun, LICSW

  • Clinical Social Worker
  • Seattle, WA
National Provider Identifier
1992149793
Registry record updated Nov 29, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LW60806047 Issued in WA
Practice address
515 3Rd Ave
Seattle, WA 98104
Phone
(206) 464-1570
NPI assigned
Apr 23, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 29, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Clinical Social Worker 1041C0700X LW60806047 WA Primary

Addresses

Primary practice location

515 3Rd Ave
Seattle, WA 98104

Mailing address

515 3Rd Ave
Seattle, WA 98104-2304
Phone (206) 464-1570

Other practice location 1

1600 E Olive St
Sound Mental Health
Seattle, WA 98122-2735
Phone (206) 302-2200

Other practice location 2

1600 E Olive St
Sound Mental Health
Seattle, WA 98122-2735
Phone (206) 302-2200

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200313000306 WA Practitioner - Clinical Social Worker 9234567819 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Counseling Services for Wellbeing, Inc. CurrentSince Apr 1, 2020 Accepting new patients

Locations

15811 Ambaum Blvd SW
Ste 110
Burien, WA 98166
Phone (206) 242-8211

Organizations & group practices 1

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": "1366675200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1543449600000",
    "number": "1992149793",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "515 3RD AVE",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981042304",
            "telephone_number": "206-464-1570"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "515 3RD AVE",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "98104",
            "telephone_number": "206-464-1570"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1600 E Olive St",
            "address_2": "Sound Mental Health",
            "address_purpose": "LOCATION",
            "city": "Seattle",
            "state": "WA",
            "postal_code": "981222735",
            "country_code": "US",
            "telephone_number": "206-302-2200",
            "fax_number": "206-302-2210",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1600 E Olive St",
            "address_2": "Sound Mental Health",
            "address_purpose": "LOCATION",
            "city": "Seattle",
            "state": "WA",
            "postal_code": "981222735",
            "country_code": "US",
            "telephone_number": "206-302-2200",
            "fax_number": "206-302-2210",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SAHAGUN",
        "first_name": "TERYN",
        "middle_name": "MICHELLE",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-04-23",
        "last_updated": "2018-11-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WA",
            "license": "LW60806047",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Seattle, WA

Sources for this page

Verify at the official NPI Registry.