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

Regina A Blackwolf, MSW, LICSW

Individual provider Addiction (Substance Use Disorder) Counselor · NPI 1184777252

Regina A Blackwolf, MSW, LICSW is a Clinical Social Worker in Everett, Washington. Qualified in 2006, 20 years ago. Accepts Medicare assignment and offers telehealth. Licensed in Washington.

Years since qualifying
20
Licensed in
WA
In the registry since
2007
Specialties on file
2
What do these letters mean?
MSW — Master of Social Work
The graduate degree in social work.
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

12812 3rd Ave SE Ste A
Everett, WA 98208-6455
Phone: (206) 375-7657
Fax: (206) 319-5325
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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 LW60083962 (WA)
Addiction (Substance Use Disorder) Counselor Taxonomy 101YA0400X · Licence CP00005962 (WA)

Record details

NPI number1184777252
Entity typeIndividual (Type 1)
GenderFemale
Credentials MSW , LICSW
Sole proprietorNo
NPI enumeratedJanuary 19, 2007
Last updated in NPPESMarch 3, 2023
Certification dateMarch 3, 2023

Medicare enrollment

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

Medicare specialtyCLINICAL SOCIAL WORKER
Medical schoolOTHER
Graduated 2006 (20 years in practice)
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services

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