Active NPI
Kristin Overman, LMHC
- Mental Health Counselor
- Mill Creek, WA
National Provider Identifier
1174944664
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- LH60634247
- Practice address
- 16300 Mill Creek Blvd
Mill Creek, WA 98012 - Phone
- (425) 215-9106
- Fax
- (208) 664-9217
- NPI assigned
- Dec 30, 2013
- 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 | LH60634247 | WA | Primary |
Addresses
Primary practice location
16300 Mill Creek Blvd
Mill Creek, WA 98012
Mailing address
5714 138TH PL SE
Everett, WA 98208
Phone (425) 215-9106
Other names 1
- Kristin Payne
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Feb 5, 2024 through Feb 5, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LH60634247 | WA | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1388361600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1540339200000",
"number": "1174944664",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5714 138TH PL SE",
"city": "EVERETT",
"state": "WA",
"postal_code": "98208",
"telephone_number": "425-215-9106",
"fax_number": "208-664-9217"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "16300 MILL CREEK BLVD",
"city": "MILL CREEK",
"state": "WA",
"postal_code": "98012",
"telephone_number": "425-215-9106",
"fax_number": "208-664-9217"
}
],
"practiceLocations": [],
"basic": {
"last_name": "OVERMAN",
"first_name": "KRISTIN",
"credential": "LMHC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-12-30",
"last_updated": "2018-10-24",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "WA",
"license": "LH60634247",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "KRISTIN",
"last_name": "PAYNE",
"credential": "LPC",
"code": "5",
"type": "Other Name"
}
]
}Other providers in Mill Creek, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2018; 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.