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ETHAN MCCORMACK LICSW
NPI 1942612494
Social Worker in Seattle, WA

Active since June 02, 2014PECOS Enrolled
4540 SAND POINT WAY NE STE 200, SEATTLE, WA 98105(206) 987-2000 Get Directions Write a Review

NPPES record last updated: January 28, 2022. Verified against the NPPES registry weekly; last sync: November 08, 2026.

Record update history: Jan 28, 2022, Mar 17, 2021, Mar 28, 2017 (3 updates tracked since 2017).

About Ethan Mccormack Licsw NPPES

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

ETHAN MCCORMACK LICSW (NPI 1942612494) is an individual social worker in Seattle, Washington, licensed in Washington (LW60626693) and active in the NPI registry since June 2014. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1942612494
Entity TypeIndividualMale
Primary Taxonomy104100000X
Provider Legal NameETHAN MCCORMACKCredential: LICSW
Location Address4540 SAND POINT WAY NE STE 200Seattle, WA 98105-3941
Mailing Address4800 Sand Point Way NeSeattle, WA 98105-3901 · (206) 987-2000
Phone(206) 987-2000
Sole ProprietorNo
Enumeration DateJune 2, 2014
Last NPPES UpdateJanuary 28, 20223 updates tracked since enumeration
NPPES CertifiedJanuary 28, 2022
✔ NPI 1942612494 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtySocial WorkerBehavioral Health & Social Service Providers
Taxonomy Code104100000X
License✔ Licensed in WA · LW60626693
Definition
A social worker is a person who is qualified by a Social Work degree, and licensed, certified or registered by the state as a social worker to practice within the scope of that license. A social worker provides assistance and counseling to clients and their families who are dealing with social, emotional and environmental problems. Social work services may be rendered to individuals, families, groups, and the public.
Also ListedCounselor · Mental HealthTaxonomy 101YM0800X · License 6801094378 (MI)
Also ListedSocial Worker · ClinicalTaxonomy 1041C0700X · License LW60626693 (WA)
4540 SAND POINT WAY NE STE 200, Seattle, WA 98105
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Accepted Insurance

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

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Ethan Mccormack Licsw 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.

Medicare Billing Reassignment

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

Seattle Children's Hospital
0.2 mi
Specialist
4800 SAND POINT WAY NE
Seattle, WA 98105
  • Reassigned Medicare billing, Washington enrollment
  • Medicare enrollment name: Seattle Childrens Hospital
  • 912 clinicians in this Medicare group
NPI 1003319500 (206) 987-2000

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

Other Providers at the Same Location NPPES 3

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

CRYSTAL-ROSE BRIDGETT CUELLAR M.D.
Pediatrics (Adolescent Medicine)
4540 SAND POINT WAY NE STE 200
SEATTLE, WA 98105
King County (206) 987-2028
CAITLIN WHITNEY CAMFIELD MD
Student in an Organized Health Care Education/Training Program
4540 SAND POINT WAY NE STE 200
SEATTLE, WA 98105
King County (206) 987-4414
CAROLYN MCCARTY
Psychologist (Clinical Child & Adolescent)
4540 SAND POINT WAY NE STE 200
SEATTLE, WA 98105
King County (206) 987-2028

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 Ethan Mccormack's NPI number?

The NPI number for Ethan Mccormack is 1942612494. It was assigned to this individual provider in the NPPES registry on June 2, 2014.

Where is Ethan Mccormack located?

Ethan Mccormack practices at 4540 Sand Point Way NE Ste 200, Seattle, WA 98105. The listed phone number is (206) 987-2000.

What is Ethan Mccormack's specialty?

The primary specialty registered for this NPI is Social Worker with taxonomy code 104100000X.

Is Ethan Mccormack enrolled in Medicare?

Yes. Ethan Mccormack is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Ethan Mccormack's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Ethan Mccormack reassigns Medicare benefits to Seattle Children's Hospital (Seattle, WA). 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 Ethan Mccormack's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Ethan Mccormack accept?

Health plans from Ambetter Health and Premera Blue Cross Blue Shield of Alaska list Ethan Mccormack 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 Ethan Mccormack was last updated on January 28, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years 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.