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KENNEDY OLIVIA FOWLE LCSW
NPI 1205537594
Social Worker - Clinical in Seattle, WA

Active since March 14, 2023PECOS EnrolledAccepts Medicare Assignment
904 7TH AVE, SEATTLE, WA 98104(206) 292-2249 Get Directions Write a Review

NPPES record last updated: December 17, 2025. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Dec 17, 2025, Aug 30, 2023, Mar 14, 2023 (3 updates tracked since 2023).

About Kennedy Olivia Fowle Lcsw NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

KENNEDY OLIVIA FOWLE LCSW (NPI 1205537594) is an individual clinical provider in Seattle, Washington, licensed in Washington (SWIA.SC.61311159) and active in the NPI registry since March 2023. She is enrolled in Medicare PECOS and is a graduate of Other (2022).

NPPES Registry Identity

NPI1205537594
Entity TypeIndividualFemale
Primary Taxonomy1041C0700X
Provider Legal NameKENNEDY OLIVIA FOWLECredential: LCSW
Location Address904 7TH AVESeattle, WA 98104-1132
Mailing AddressPo Box 5127Everett, WA 98206-5127
Phone(206) 292-2249
Sole ProprietorYes
Medical School CMSOtherGraduated 2022
Enumeration DateMarch 14, 2023
Last NPPES UpdateDecember 17, 20253 updates tracked since enumeration
NPPES CertifiedDecember 17, 2025
✔ NPI 1205537594 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySocial Worker · ClinicalBehavioral Health & Social Service Providers
Taxonomy Code1041C0700X
License✔ Licensed in WA · SWIA.SC.61311159
Definition
A social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances.
904 7TH AVE, Seattle, WA 98104
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include BridgeSpan Health Company, Premera Blue Cross Blue Shield of Alaska, Providence Health Plan and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Kennedy Olivia Fowle Lcsw is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID1951897180
PECOS Enrollment IDI20251226001049
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Kennedy Fowle reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Full Moon Wellness And Consulting, LLC
152 mi
Clinical
7155 SW VARNS ST STE 215
Portland, OR 97223
  • Reassigned Medicare billing, Oregon enrollment
  • 2 clinicians in this Medicare group
NPI 1952123861 (503) 894-7144

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 98104 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$0.00 typical visit price
range $63.67 – $189.37
Typical copayment $0.00 (range $15.91 – $47.34)
Most-billed visit code NA
Established Patient
$78.74 typical visit price
range $21.12 – $155.00
Typical copayment $19.68 (range $5.28 – $38.75)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

LAURA MORRISON MD
Dermatology
904 7TH AVE
SEATTLE, WA 98104
King County (206) 860-4691
DR. JOSEPH W DAVIS M.D.
Internal Medicine
904 7TH AVE
SEATTLE, WA 98104
King County (206) 860-5574
MANDY WARNER MATTA PA-C
Physician Assistant (Surgical)
904 7TH AVE
SEATTLE, WA 98104
King County (206) 329-1760
ANTONIUS MULIA M.D.
Internal Medicine
904 7TH AVE
SEATTLE, WA 98104
King County (206) 329-1760
KATHLEEN MAKIELSKI M.D.
Otolaryngology
904 7TH AVE
SEATTLE, WA 98104
King County (206) 329-1760
DR. XIANGPING REN MD
Physical Medicine & Rehabilitation (Pain Medicine)
904 7TH AVE
SEATTLE, WA 98104
King County (206) 329-1760
ANNA H STEPCZYNSKI M.D.
Internal Medicine
904 7TH AVE
SEATTLE, WA 98104
King County (206) 860-5574
NEHA MITRAGOTRI
Pediatrics
904 7TH AVE
SEATTLE, WA 98104
King County (206) 292-2249

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Kennedy Fowle's NPI number?

The NPI number for Kennedy Fowle is 1205537594. It was assigned to this individual provider in the NPPES registry on March 14, 2023.

Where is Kennedy Fowle located?

Kennedy Fowle practices at 904 7th Ave, Seattle, WA 98104. The listed phone number is (206) 292-2249.

What is Kennedy Fowle's specialty?

The primary specialty registered for this NPI is Social Worker, specializing in Clinical, with taxonomy code 1041C0700X.

Is Kennedy Fowle enrolled in Medicare?

Yes. Kennedy Fowle is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organization bills Medicare for Kennedy Fowle's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Kennedy Fowle reassigns Medicare benefits to Full Moon Wellness And Consulting, LLC (Portland, OR). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Kennedy Fowle's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Kennedy Fowle accept?

Health plans from BridgeSpan Health Company, Premera Blue Cross Blue Shield of Alaska, Providence Health Plan and Regence BlueCross BlueShield of Oregon list Kennedy Fowle as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Kennedy Fowle was last updated on December 17, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.