Individual provider Active NPI

Kelly Mae Smith Costello

  • Mental Health Counselor
  • Wenatchee, WA
National Provider Identifier
1023723210
Registry record updated Jan 7, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
LH70024621 Issued in WA
Practice address
1230 Monitor St
Wenatchee, WA 98801-3534
Phone
(509) 300-1221
NPI assigned
Jan 23, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 7, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X LH70024621 WA Primary

Addresses

Primary practice location

1230 Monitor St
Wenatchee, WA 98801-3534

Mailing address

1230 Monitor St
Wenatchee, WA 98801-3534
Phone (509) 300-1221

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260116001933 WA Practitioner - Mental Health Counselor 1153808456 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Mindful Therapy Group PCGroup PAC ID 4981872561, 654 clinicians

Practice addresses (Care Compare)

6505 216TH St SW
Suite 100
Mountlake Terrace, WA 98043-2089
Phone (425) 640-7009

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LH70024621WAMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Mindful Therapy Group PC Mental Health CurrentSince Jan 7, 2026 Accepting new patients
Grow Healthcare Group PA Mental Health CurrentSince Jan 27, 2026 Accepting new patients

Locations

6505 216th St SW
Ste 100
Mountlake Terrace, WA 98043
Phone (425) 678-6463

21907 64th Ave W
Ste 200
Mountlake Terrace, WA 98043
Phone (410) 258-3698

320 NE 97th St
Ste A
Seattle, WA 98115
Phone (206) 323-8113

201 W North River Dr
Ste 301
Spokane, WA 99201
Phone (509) 496-0724

Networks

  • WA PPO C-SNP
  • devoted network organization-83621310-88c0-4660-8f8d-b8ea8f4dc04e

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1674432000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1767744000000",
    "number": "1023723210",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1230 MONITOR ST",
            "city": "WENATCHEE",
            "state": "WA",
            "postal_code": "988013534",
            "telephone_number": "509-300-1221"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1230 MONITOR ST",
            "city": "WENATCHEE",
            "state": "WA",
            "postal_code": "988013534",
            "telephone_number": "509-300-1221"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH COSTELLO",
        "first_name": "KELLY",
        "middle_name": "MAE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-01-23",
        "last_updated": "2026-01-07",
        "certification_date": "2026-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WA",
            "license": "LH70024621",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wenatchee, WA

Sources for this page

Verify at the official NPI Registry.