ETHAN MCCORMACK LICSW
NPI 1942612494
Social Worker in Seattle, WA

Q: 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.

Q: What is Ethan Mccormack's specialty?

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

Q: 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.

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: August 09, 2026.

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

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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 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 (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.

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.

What insurance does Ethan Mccormack accept?

Health plans from PacificSource Health Plans 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.