IndividualActive
Tammy Countryman, LICSW
NPI 1073058400 · Clinical Social Worker · Moses Lake, WA
Provider details
- NPI number
- 1073058400
- Entity type
- Individual
- Primary specialty
- Clinical Social WorkerBehavioral Health & Social Service Providers
- Credential
- LICSW
- Sex
- Female
- Sole proprietor
- No
- License
- SC60925928 (WA)
Specialties & taxonomies
Behavioral Health & Social Service Providers
Behavioral Health & Social Service Providers
Behavioral Health & Social Service Providers
Profile Score
Detailed profile(75/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
9 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
2 documented practice locations
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
605 S Coolidge St
Moses Lake, WA 98837-1873
Phone: (509) 764-6111
Street-level locationGet directions
Mailing address
605 S Coolidge St
Moses Lake, WA 98837-1873
Additional practice locations (1)
- 1742 Oregon StRedding, CA 96001-1717Phone: (530) 226-7419
Registry dates
- Enumerated
- 2016-12-20
- Last updated
- 2026-06-01
- Certified
- 2026-06-01
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.