Active NPI
Kelsey Conklin
- Mental Health Counselor
- Edmonds, WA
National Provider Identifier
1154460582
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- RC00057084
- Practice address
- 547 Dayton St
Edmonds, WA 98020-3431 - Phone
- (425) 771-5166
- Fax
- (425) 670-2807
- NPI assigned
- Feb 5, 2007
- Last updated
- Jul 8, 2007
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | RC00057084 | WA | Primary |
Addresses
Primary practice location
547 Dayton St
Edmonds, WA 98020-3431
Mailing address
10202 50TH PL W
Mukilteo, WA 98275-4222
Phone (425) 771-5166
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RC00057084 | WA | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1170633600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1154460582",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10202 50TH PL W",
"city": "MUKILTEO",
"state": "WA",
"postal_code": "982754222",
"telephone_number": "425-771-5166",
"fax_number": "425-670-2807"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "547 DAYTON ST",
"city": "EDMONDS",
"state": "WA",
"postal_code": "980203431",
"telephone_number": "425-771-5166",
"fax_number": "425-670-2807"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CONKLIN",
"first_name": "KELSEY",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-02-05",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "WA",
"license": "RC00057084",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Edmonds, WA
- Community Health Center of Snohomish County (Community Health Center of Snohomish County Edmonds Pharmacy)
- Community Health Center of Snohomish County
- Community Support Solutions
- Complete Vein Care PLLC (Complete Vein Care)
- Sally L Condon, MD
- Kathryn Conkling, ARNP
- Connect and Thrive, PLLC (Connect Integrative Medicine)
- Convalescent Equipment & Supply Co. Inc.
- Derek Kevin Cooper, LMHC, LCPC
- Sheryl L Copeland, LMHC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.