Active NPI
Brooke Ann Kennaugh, MA
- Professional Counselor
- Seattle, WA
National Provider Identifier
1023030400
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- LPC-3447
- Practice address
- 1800 Westlake Ave North
Suite 105
Seattle, WA 98109 - Phone
- (208) 733-7186
- Fax
- (208) 733-7178
- NPI assigned
- Jul 24, 2006
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | LPC-3447 | ID | Primary |
Addresses
Primary practice location
1800 Westlake Ave North
Suite 105
Seattle, WA 98109
Mailing address
5041-112TH Ave NE
Kirkland, WA 98033
Phone (206) 930-4930
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LPC-3447 | ID | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153699200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1351036800000",
"number": "1023030400",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5041-112TH AVE NE",
"city": "KIRKLAND",
"state": "WA",
"postal_code": "98033",
"telephone_number": "206-930-4930",
"fax_number": "208-733-7178"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1800 WESTLAKE AVE NORTH",
"address_2": "SUITE 105",
"city": "SEATTLE",
"state": "WA",
"postal_code": "98109",
"telephone_number": "208-733-7186",
"fax_number": "208-733-7178"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KENNAUGH",
"first_name": "BROOKE",
"middle_name": "ANN",
"name_prefix": "Mrs.",
"credential": "MA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-07-24",
"last_updated": "2012-10-24",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "ID",
"license": "LPC-3447",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Seattle, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.