Individual provider Active NPI

Melissa Keddington, M.A.

  • Mental Health Counselor
  • Spokane, WA
National Provider Identifier
1053820118
Registry record updated Sep 21, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Practice address
1405 E 12TH Ave
Spokane, WA 99202-3527
Phone
(509) 218-0180
NPI assigned
Sep 21, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 21, 2017

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 Primary

Addresses

Primary practice location

1405 E 12TH Ave
Spokane, WA 99202-3527

Mailing address

1718 E Lincoln Rd Apt J365
Spokane, WA 99217-7772
Phone (801) 318-7202

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT
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
I20260514000020 UT Practitioner - Marriage and Family Therapist 0840769337 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Marriage and Family Therapist
Education
Other, 2017
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

130 E Maple St
Mapleton, UT 84664-4601

360 S 670
Suite 100
Lindon, UT 84042-2094

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts

Organizations & group practices 1

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": "1505952000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1505952000000",
    "number": "1053820118",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1718 E LINCOLN RD APT J365",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992177772",
            "telephone_number": "801-318-7202"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1405 E 12TH AVE",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992023527",
            "telephone_number": "509-218-0180"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEDDINGTON",
        "first_name": "MELISSA",
        "credential": "M.A.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-09-21",
        "last_updated": "2017-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Spokane, WA

Sources for this page

Verify at the official NPI Registry.