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Ethan Mccormack , LICSW

Social Worker β€’ Seattle, WA

Active NPI 1942612494 Individual Practitioner Male Practitioner
Practice location in NPPES

4540 Sand Point Way Ne Ste 200
Seattle, WA 981053941

Call 2069872000 Location details and other listings
Medical Disclaimer

This profile restates public CMS/NPPES data; T-MedInfo gives no medical advice — consult a licensed professional, and call 911 for emergencies.

Practice Location & Contact Primary Location

Practice Address

4540 Sand Point Way Ne Ste 200

Seattle, WA 981053941

Telephone 2069872000
Organization at the Same NPPES Address or Phone
Seattle Children's Hospital Facility NPI 1003319500

Matched by practice address or phone in NPPES. A shared address or phone does not confirm that this clinician works there.

NPI first issued

2014

The year this clinician's National Provider Identifier (NPI) was issued. An NPI is a unique 10-digit ID that US health care providers use for billing.

What this does not show: NPI first issued

NPIs have been issued only since 2005, so this year is not necessarily when the clinician started practicing.

Source: CMS NPPES NPI Registry.

Medicare assignment not listed

CMS data do not show whether this clinician accepts Medicare assignment. This does not mean they do not accept Medicare. Ask the office.

Medicare assignment applies to Original Medicare. It does not tell you whether the clinician is in a Medicare Advantage plan's network, accepts other insurance, or is taking new patients.

Source: CMS Doctors and Clinicians; Medicare.gov, β€œDoes your provider accept Medicare as full payment?”

Guide: What Medicare assignment means

No telehealth indicator

CMS shows this indicator only when recent Medicare claims include telehealth services. The clinician may still offer telehealth; ask the office.

Source: CMS, Telehealth Indicator on Medicare Care Compare (fact sheet, January 2023); CMS Doctors and Clinicians.

Guide: How Medicare covers telehealth

Enrolled in Medicare (PECOS)

Ethan Mccormack has a Medicare enrollment record in PECOS, the CMS system clinicians use to enroll so they can bill Medicare or order services for people with Medicare.

It does not show whether the clinician accepts assignment, is in your plan's network, or is taking new patients.

Source: CMS Medicare Fee-For-Service Public Provider Enrollment (PECOS); CMS Order and Referring file.

Guide: What Medicare enrollment (PECOS) means

Can order Medicare-covered services

CMS lists Ethan Mccormack as eligible to order or refer Medicare Part B clinical laboratory and imaging services and durable medical equipment (DME) for people with Medicare.

What this does not show: Can order Medicare-covered services

It does not mean the clinician offers these services directly.

Source: CMS Medicare Fee-For-Service Public Provider Enrollment (PECOS); CMS Order and Referring file.

Guide: What ordering and referring status means

Compared with the same specialty in Seattle and Washington

468 active clinicians are listed under Social Worker with a practice address in Seattle, WA (2,142 in Washington).

Addresses are self-reported to NPPES and may be out of date.

Telehealth indicator in Seattle

0.9% of these 468 clinicians have the CMS telehealth indicator.

2.6% of these 468 clinicians are listed by CMS as accepting Medicare assignment.

Sources: CMS Doctors and Clinicians, CMS NPPES NPI Registry. Specialty names follow the NUCC Health Care Provider Taxonomy.

Text: T-MedInfo Β· Report an error.

Specialties & License Numbers Reported to NPPES

Self-certified to NPPES: 2022-01-28
Social Worker Primary Specialty

NUCC Taxonomy Code: 104100000X

License # reported to NPPES WA LW60626693

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.

Counselor - Mental Health

NUCC Taxonomy Code: 101YM0800X

License # reported to NPPES MI 6801094378
Counselor - Mental Health

NUCC Taxonomy Code: 101YM0800X

Social Worker - Clinical

NUCC Taxonomy Code: 1041C0700X

License # reported to NPPES WA LW60626693

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.

Check License Status with the State Board License numbers are self-reported to NPPES; T-MedInfo does not confirm them against state records. Current status: Washington State Department of Health Provider Lookup.
Look Up on State Board Site

Medicare (PECOS) Enrollment & Ordering Eligibility

Source: CMS PECOS
Medicare FFS Enrollment Status Medicare Enrollment on File
CMS Provider Specialty

PRACTITIONER - CLINICAL SOCIAL WORKER

Medicare Enrollment ID

I20160930000753

Enrollment State Jurisdiction

WA

PECOS Control ID

2163719469

Medicare Order & Referring Eligibility
Clinical Lab & Imaging (Part B) Eligible
Durable Medical Equipment (DME) Eligible
Home Health Agency (HHA) Not Eligible
Power Mobility Devices (PMD) Not Eligible

Sources: CMS Provider Enrollment and Order and Referring. Medicare enrollment is a billing status, not an accreditation or quality rating.

Clinicians Sharing This Practice Address or Phone

Clinicians sharing this NPPES address, phone or fax; a shared contact does not mean they work together.

2 listed
Dr. Rachel Kay , MD

Psychiatry & Neurology - Psychiatry

NPI 1013470434

Doctor of Medicine (M.D.)

NPI 1013168673

Doctor of Medicine (M.D.)

Career & Practice History Timeline

Changes recorded in monthly NPPES data files: addresses, names, credentials, specialties and NPI status

15 Historical Events
πŸ“
Updated Practice Location March 17, 2021

Registered at 4540 SAND POINT WAY NE STE 200, SEATTLE, WA 981053941 (Tel: 2069872000)

πŸ“
Updated Business Mailing Address March 17, 2021

Registered at 4800 SAND POINT WAY NE, SEATTLE, WA 981053901 (Tel: 2069872000)

πŸ‘€
Provider Name / Credentials Updated March 17, 2021

Recorded as ETHAN MCCORMACK, LICSW

πŸŽ“
Medical Taxonomy / Specialty Registered (Primary Specialty) March 17, 2021

Counselor (license number reported to NPPES: MI 6801094378)

βœ…
NPI Profile Active March 28, 2017

NPI status registered as active in NPPES database

πŸ“
Updated Practice Location March 28, 2017

Registered at 2600 SW HOLDEN ST, SEATTLE, WA 981263505 (Tel: 2069337000)

πŸ“
Updated Business Mailing Address March 28, 2017

Registered at 1210 SW 136TH ST, BURIEN, WA 981661214 (Tel: 2062576600)

πŸ‘€
Provider Name / Credentials Updated March 28, 2017

Recorded as ETHAN BLUSTEIN, LICSW

πŸŽ“
Medical Taxonomy / Specialty Registered (Primary Specialty) March 28, 2017

Counselor (license number reported to NPPES: MI 6801094378)

βœ…
NPI Profile Active May 25, 2016

NPI status registered as active in NPPES database

πŸ“
Practice Location (Initial Record) May 25, 2016

Registered at 4238 AUBURN WAY N, AUBURN, WA 980021311 (Tel: 2538767600)

πŸ“
Business Mailing Address (Initial Record) May 25, 2016

Registered at 1600 E OLIVE ST, SEATTLE, WA 981222735 (Tel: 2063022200)

πŸ‘€
Provider Name / Credentials (Initial Record) May 25, 2016

Recorded as ETHAN BLUSTEIN, LICSW

πŸŽ“
Medical Taxonomy / Specialty Registered (Primary Specialty) May 25, 2016

Counselor

🟒
Initial NPI Registration & Enumeration June 02, 2014

First registered as active Individual Practitioner in NPPES Database.

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NPI Administrative Meta

NPI Number: 1942612494
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: June 02, 2014
Last Update: January 28, 2022
Sole Proprietor: No

Other Social Workers in Seattle

All Social Workers in Seattle

Mailing Address

4800 Sand Point Way Ne

Seattle, WA 981053901

Phone: 2069872000

About This Data NPPES fields (address, phone, specialty, license) are self-reported and may be outdated; Medicare fields follow the CMS dataset named in each section. Correct directly at NPPES.