Individual provider Active NPI

Katianne Wafstet Kelsey, LMHC

  • Mental Health Counselor
  • Spokane, WA
National Provider Identifier
1184964058
Registry record updated Nov 21, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
LH60750546 Issued in WA
Practice address
3754 W Indian Trail Rd
Spokane, WA 99208-4736
Phone
(509) 559-3100
NPI assigned
Feb 28, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 21, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X LH60750546 WA Primary

Addresses

Primary practice location

3754 W Indian Trail Rd
Spokane, WA 99208-4736

Mailing address

3754 W Indian Trail Rd
Spokane, WA 99208-4736
Phone (509) 559-3100

Other identifiers 1

IdentifierTypeStateIssuer
1184964058MedicaidWA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
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.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240214002763 WA Practitioner - Mental Health Counselor 0648614941 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Community Health Association of Spokane CurrentSince Jan 9, 2024 Accepting new patients
Excelsior Wellness CurrentSince Nov 21, 2024 Accepting new patients
Community Health Association of Spokane CurrentSince Jan 9, 2024 Accepting new patients
Community Health Association of Spokane Current Accepting new patients

Locations

1622 E Wellesley Ave
Spokane, WA 99207

1600 N Howard St
Spokane, WA 99205

1001 W 2nd Ave
Spokane, WA 99201
Phone (509) 835-1205

611 N Iron Bridge Way
Spokane, WA 99202

3754 W Indian Trail Rd
Spokane, WA 99208
Phone (509) 328-7041

15812 E Indiana Ave
Ste 200
Spokane Valley, WA 99216
Phone (509) 343-1116

Organizations & group practices 4

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": "1362009600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732147200000",
    "number": "1184964058",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3754 W INDIAN TRAIL RD",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992084736",
            "telephone_number": "509-559-3100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3754 W INDIAN TRAIL RD",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992084736",
            "telephone_number": "509-559-3100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELSEY",
        "first_name": "KATIANNE",
        "middle_name": "WAFSTET",
        "credential": "LMHC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-02-28",
        "last_updated": "2024-11-21",
        "certification_date": "2024-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WA",
            "license": "LH60750546",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1184964058",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Spokane, WA

Sources for this page

Verify at the official NPI Registry.