MR. DAVID WILDER (LICSW) – Clinical Social Worker, NPI 1366478323

MR. DAVID WILDER (LICSW) is a healthcare provider. based in Langley, Washington. specializing in CLINICAL SOCIAL WORKER. They hold the professional credentials LICSW. They hold a License No. LW00005030 (WA). The NPI Number for MR. DAVID WILDER (LICSW) is 1366478323

Main info

Male
Sole Proprietor
39 Years Of Experience
Accepts Medicare Assignment
Name
MR. DAVID WILDER (LICSW)
NPI
1366478323
Phone
(360) 341-3562
Address
PO BOX 842
Enumeration Date
23 June 2006
Last Update Date
17 March 2014

Doctor Profile

Medical School Name
OTHER
Secondary Phone
-
Graduation Year
1987 (39 years ago)
PAC ID
5799913380
Professional Enrollment ID
I20140103000888
Address ID
WA982609229La919XXSTXX301
Telehealth
Yes
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience52
Completeness75
Years active:19State licenses:1Digital endpointsOther names

1,397 CLINICAL SOCIAL WORKER in WA

Provider Addresses for MR. DAVID WILDER (LICSW)

  • PO BOX 842

    LANGLEY, WA 982600842

    Phone: (360) 341-3562

    Fax: (360) 221-2515

    Type: Mailing

  • 919 3RD ST STE 101

    LANGLEY, WA 982609229

    Phone: (360) 341-3562

    Fax: (360) 221-2515

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2014-01-03

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20140103000888IClinical Social WorkerWATBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
90837Psychotherapy, 1 hour24717$0
View full utilization report →

Insurance plans in this area (ZIP 98260)

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Reviews

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Frequently asked questions

How do I look up MR. DAVID WILDER (LICSW) by NPI?
Use NPI 1366478323 when you need to reference MR. DAVID WILDER (LICSW) in forms, claims, or directories.
Is MR. DAVID WILDER (LICSW)'s enrollment marked active?
An active flag here means the NPI record is not in a deactivated state.
Can you summarize MR. DAVID WILDER (LICSW)'s specialty in plain language?
Clinically, the directory lists MR. DAVID WILDER (LICSW) with Clinical Social Worker. Clinical services aligned with this taxonomy classification.
What location shows for MR. DAVID WILDER (LICSW)?
We surface Langley, Washington for MR. DAVID WILDER (LICSW) based on available NPPES addresses.
Does Medicare enrollment show here?
Medicare enrollment screens are separate from the basic NPI extract shown here.

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