Kristina Marie Spurlock, MA, LMHC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

LH60983431 Issued in WA

Practice address

16300 Mill Creek Blvd Ste 119
Mill Creek, WA 98012-1278

Phone

(425) 522-2105

Fax

(425) 472-1112

NPI assigned

Oct 3, 2017

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Mar 6, 2024 through Mar 6, 2028

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

State licenses

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

{
    "created_epoch": "1506988800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712188800000",
    "number": "1053821132",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16300 MILL CREEK BLVD STE 119",
            "city": "MILL CREEK",
            "state": "WA",
            "postal_code": "980121278",
            "telephone_number": "425-522-2105",
            "fax_number": "425-472-1112"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16300 MILL CREEK BLVD STE 119",
            "city": "MILL CREEK",
            "state": "WA",
            "postal_code": "980121278",
            "telephone_number": "425-522-2105",
            "fax_number": "425-472-1112"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3322 Broadway",
            "address_purpose": "LOCATION",
            "city": "Everett",
            "state": "WA",
            "postal_code": "982014425",
            "country_code": "US",
            "telephone_number": "425-349-6800",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1116 Summit Ave",
            "address_purpose": "LOCATION",
            "city": "Seattle",
            "state": "WA",
            "postal_code": "981012831",
            "country_code": "US",
            "telephone_number": "206-323-0930 x1315",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SPURLOCK",
        "first_name": "KRISTINA",
        "middle_name": "MARIE",
        "credential": "MA, LMHC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-10-03",
        "last_updated": "2024-04-04",
        "certification_date": "2024-04-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WA",
            "license": "MC60797899",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WA",
            "license": "LH60983431",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MENTAL HEALTH COUNSELING LICENSE",
            "identifier": "LH60983431",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSURE",
            "identifier": "MC60797899",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Mental Health Counselor in Mill Creek, WA
• Providers in Mill Creek, WA by specialty
• Mental Health Counselor in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.