AMBER FAWN GENTRYSOUTHARD M.S.W, LICSW
NPI 1902079924
Social Worker - Clinical in Puyallup, WA

Q: What is Amber Gentrysouthard's NPI number?

The NPI number for Amber Gentrysouthard is 1902079924. It was assigned to this individual provider in the NPPES registry on April 10, 2008.

Q: What is Amber Gentrysouthard's specialty?

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

Active since April 10, 2008PECOS EnrolledAccepts Medicare Assignment

325 E PIONEER, PUYALLUP, WA 98372(253) 445-8120(253) 697-3730 Get Directions Write a Review

NPPES record last updated: April 26, 2012. Verified against the NPPES registry weekly; last sync: August 30, 2026.

On this page

About Amber Fawn Gentrysouthard M.s.w, Licsw NPPES

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

AMBER FAWN GENTRYSOUTHARD M.S.W, LICSW (NPI 1902079924) is an individual clinical provider in Puyallup, Washington, licensed in Washington (LW 60072190) and active in the NPI registry since April 2008. She is enrolled in Medicare PECOS and is a graduate of Other (2005).

NPPES Registry Identity

NPI1902079924

Entity TypeIndividualFemale

Primary Taxonomy1041C0700X

Provider Legal NameAMBER FAWN GENTRYSOUTHARDCredential: M.S.W, LICSW

Location Address325 E PIONEERPuyallup, WA 98372-3265

Mailing Address325 E PioneerPuyallup, WA 98372-3265 · (253) 445-8120 · Fax (253) 697-3730

Phone(253) 445-8120

Fax(253) 697-3730

Sole ProprietorNo

Medical School CMSOtherGraduated 2005

Enumeration DateApril 10, 2008

Last NPPES UpdateApril 26, 2012

✔ NPI 1902079924 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 · LW 60072190

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.

325 E PIONEER, Puyallup, WA 98372

Open in Google Maps ↗

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include PacificSource Health Plans, Premera Blue Cross Blue Shield of Alaska.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Amber Fawn Gentrysouthard M.s.w, Licsw 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 ID4587827209

PECOS Enrollment IDI20120516000523

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 98372 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.

RAINY D THOMPSON

Counselor (Mental Health)