JESSICA ANN SUMMERVILLE
NPI 1770063646
Social Worker - Clinical in Vancouver, WA

Q: What is Jessica Summerville's NPI number?

The NPI number for Jessica Summerville is 1770063646. It was assigned to this individual provider in the NPPES registry on August 20, 2018.

Q: What is Jessica Summerville's specialty?

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

Active since August 20, 2018PECOS Enrolled

1498 SE TECH CENTER PL STE 300, VANCOUVER, WA 98683(360) 200-8756 Get Directions Write a Review

NPPES record last updated: January 23, 2025. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Jan 10, 2019, Aug 20, 2018 (2 updates tracked since 2018).

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About Jessica Ann Summerville NPPES

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

JESSICA ANN SUMMERVILLE (NPI 1770063646) is an individual clinical provider in Vancouver, Washington, licensed in Washington (LW61396047) and active in the NPI registry since August 2018. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1770063646

Entity TypeIndividualFemale

Primary Taxonomy1041C0700X

Provider Legal NameJESSICA ANN SUMMERVILLE

Location Address1498 SE TECH CENTER PL STE 300Vancouver, WA 98683-5509

Mailing Address1498 Se Tech Center Pl Ste 300Vancouver, WA 98683-5509 · (360) 560-8846

Phone(360) 200-8756

Sole ProprietorYes

Enumeration DateAugust 20, 2018

Last NPPES UpdateJanuary 23, 20252 updates tracked since enumeration

NPPES CertifiedJanuary 23, 2025

✔ NPI 1770063646 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtySocial Worker · ClinicalBehavioral Health & Social Service Providers

Taxonomy Code1041C0700X

License✔ Licensed in WA · LW61396047

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.

Also ListedCounselor · Mental HealthTaxonomy 101YM0800X · License LH61164216 (WA)

1498 SE TECH CENTER PL STE 300, Vancouver, WA 98683

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Other Identifiers 1

Medicaid911585652WA

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include BridgeSpan Health Company, Kaiser Permanente, Moda Health Plan, Inc. and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Jessica Ann Summerville is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 98683 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 $57.27 – $172.80

Typical copayment $0.00 (range $14.31 – $43.20)

Most-billed visit code NA

Established Patient

$71.29 typical visit price

range $18.56 – $141.11

Typical copayment $17.82 (range $4.64 – $35.27)

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.

MR. JOSEPH MELVIN KLEMZ LICSW

Social Worker (Clinical)