Active NPI
Keenya King, SOCIAL WORKER
- Counselor
- Vancouver, WA
National Provider Identifier
1063101673
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counselor
- Practice address
- 2500 NE 65TH Ave
Vancouver, WA 98661-6812 - Phone
- (360) 750-7500
- NPI assigned
- May 1, 2023
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | Primary | ||
| Clinical Social Worker | 1041C0700X |
Addresses
Primary practice location
2500 NE 65TH Ave
Vancouver, WA 98661-6812
Mailing address
2500 NE 65TH Ave
Vancouver, WA 98661-6812
Phone (360) 750-7500
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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Educational Service District 112 | Past | Accepting new patients |
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.
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Vancouver, WA
- NPI 1790008928
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1682899200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1763596800000",
"number": "1063101673",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2500 NE 65TH AVE",
"city": "VANCOUVER",
"state": "WA",
"postal_code": "986616812",
"telephone_number": "360-750-7500"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2500 NE 65TH AVE",
"city": "VANCOUVER",
"state": "WA",
"postal_code": "986616812",
"telephone_number": "360-750-7500"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KING",
"first_name": "KEENYA",
"credential": "SOCIAL WORKER",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-05-01",
"last_updated": "2025-11-20",
"certification_date": "2025-11-20",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": null,
"license": null,
"primary": true
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Vancouver, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.