Kelly Lynn Samli, MA, LMHC, ADHD-CCSP

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

LH60796061 Issued in WA

Practice address

22232 17TH Ave SE Ste 302
Bothell, WA 98021-7425

Phone

(425) 487-1005

Fax

(425) 487-4884

NPI assigned

Jan 26, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Apr 15, 2024 through Apr 15, 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": "1516924800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743724800000",
    "number": "1083112817",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8623 NE 24TH ST",
            "city": "CLYDE HILL",
            "state": "WA",
            "postal_code": "980042428",
            "telephone_number": "425-463-9062"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22232 17TH AVE SE STE 302",
            "city": "BOTHELL",
            "state": "WA",
            "postal_code": "980217425",
            "telephone_number": "425-487-1005",
            "fax_number": "425-487-4884"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAMLI",
        "first_name": "KELLY",
        "middle_name": "LYNN",
        "credential": "MA, LMHC, ADHD-CCSP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-01-26",
        "last_updated": "2025-04-04",
        "certification_date": "2025-04-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WA",
            "license": "LH60796061",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kaori A Sakurai, MD
• Cynthia Bascara Salazar-Rubio, RN
• Amir H Salehi, DENTURIST L.D.
• Brian Sallin
• Hoda Samia, M.D.
• Merin Eva Sampath
• Kendra Dale Sampson, MSW
• Talisa Sampson
• Derynne Samson, LMHC
• Michelle M Sanchez-Balbuena

• Mental Health Counselor in Bothell, WA
• Providers in Bothell, 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, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.