Individual provider Active NPI

Young Kwang Ju, LMFT

  • Marriage & Family Therapist
  • Bellevue, WA
National Provider Identifier
1164741682
Registry record updated Oct 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
LF61619910 Issued in WA
Practice address
375 118TH Ave SE Ste 204
Bellevue, WA 98005-3525
Phone
(858) 863-6311
NPI assigned
May 24, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 8, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X
Marriage & Family Therapist 106H00000X LF61619910 WA Primary

Addresses

Primary practice location

375 118TH Ave SE Ste 204
Bellevue, WA 98005-3525

Mailing address

375 118TH Ave SE Ste 204
Bellevue, WA 98005-3525
Phone (858) 863-6311

Other practice location 1

1202 Morena Blvd Ste 203
San Diego, CA 92110-3843
Phone (619) 398-3261

Medicare participation

Medicare enrollment files
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 16, 2024 through Apr 16, 2028

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
LF61619910WAMDMarriage & Family Therapist
88568CAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Young Ju Counseling PLLC Marriage & Family Therapist CurrentSince Oct 12, 2025 Accepting new patients

Locations

375 118th Ave SE
Ste 204
Bellevue, WA 98005
Phone (206) 317-4388

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": "1274659200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759881600000",
    "number": "1164741682",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "375 118TH AVE SE STE 204",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980053525",
            "telephone_number": "858-863-6311"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "375 118TH AVE SE STE 204",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980053525",
            "telephone_number": "858-863-6311"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1202 Morena Blvd Ste 203",
            "address_purpose": "LOCATION",
            "city": "San Diego",
            "state": "CA",
            "postal_code": "921103843",
            "country_code": "US",
            "telephone_number": "619-398-3261",
            "fax_number": "619-275-2023",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JU",
        "first_name": "YOUNG",
        "middle_name": "KWANG",
        "name_prefix": "Mr.",
        "credential": "LMFT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-05-24",
        "last_updated": "2025-10-08",
        "certification_date": "2025-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "WA",
            "license": "LF61619910",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bellevue, WA

Sources for this page

Verify at the official NPI Registry.