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

Tammy Countryman, LICSW

Individual provider Clinical Social Worker · NPI 1073058400

Tammy Countryman, LICSW is a Clinical Social Worker in Moses Lake, Washington. Qualified in 2018, 8 years ago. Practices with Moses Lake Community Health Center, a 78-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in California and Washington.

Years since qualifying
8
Licensed in
CA, WA
In the registry since
2016
Specialties on file
3
What do these letters mean?
LICSW — Licensed Independent Clinical Social Worker
The title some states use for an independently practising clinical social worker.

See every abbreviation used in this directory →

Practice location Address checks out

605 S Coolidge St
Moses Lake, WA 98837-1873
Phone: (509) 764-6111
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 1742 Oregon St, Redding, CA 96001-1717 — (530) 226-7419

Specialties & licences

Clinical Social Worker (primary) Taxonomy 1041C0700X · Licence LW61412156 (WA)
Clinical Social Worker Taxonomy 1041C0700X · Licence SC60925928 (WA)
Clinical Social Worker Taxonomy 1041C0700X · Licence 95929 (CA)

Record details

NPI number1073058400
Entity typeIndividual (Type 1)
GenderFemale
Credentials LICSW
Sole proprietorNo
NPI enumeratedDecember 20, 2016
Last updated in NPPESJune 1, 2026
Certification dateJune 1, 2026

Medicare enrollment

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

Medicare specialtyCLINICAL SOCIAL WORKER
Medical schoolOTHER
Graduated 2018 (8 years in practice)
Group practice Moses Lake Community Health Center — 78 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

Other providers in Moses Lake