Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Kim E Rodgers, LICSW

Individual provider Clinical Social Worker · NPI 1750889168

Kim E Rodgers, LICSW is a Clinical Social Worker in Everett, Washington. Qualified in 2003, 23 years ago. Practices with Mindful Therapy Group PC, a 646-clinician group, accepts Medicare assignment and offers telehealth. Licensed in Washington.

Years since qualifying
23
Licensed in
WA
In the registry since
2018
What do these letters mean?
LICSW — Licensed Independent Clinical Social Worker
The title some states use for an independently practising clinical social worker.

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Practice location Address checks out

4201 Rucker Ave
Everett, WA 98203-2215
Phone: (425) 382-4000
Fax: (425) 382-4001
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinical Social Worker (primary) Taxonomy 1041C0700X · Licence LW60048741 (WA)

Record details

NPI number1750889168
Entity typeIndividual (Type 1)
GenderFemale
Credentials LICSW
Sole proprietorNo
NPI enumeratedJanuary 31, 2018
Last updated in NPPESJanuary 20, 2022
Certification dateJanuary 20, 2022
Mailing address8609 Evergreen Way, Everett, WA 98208-2619

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyCLINICAL SOCIAL WORKER
Medical schoolOTHER
Graduated 2003 (23 years in practice)
Group practice Mindful Therapy Group Pc — 646 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services

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