Individual provider Active NPI

Emery Killian Nelsen-Barbosa, LMFT

  • Marriage & Family Therapist
  • Seattle, WA
National Provider Identifier
1215404397
Registry record updated May 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
LF61186433 Issued in WA
Practice address
2366 Eastlake Avenue East #402
Seattle, WA 98102-1621
Phone
(360) 329-2003
NPI assigned
Oct 26, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 7, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X LF61186433 WA Primary

Addresses

Primary practice location

2366 Eastlake Avenue East #402
Seattle, WA 98102-1621

Mailing address

2366 Eastlake Avenue East #402
Seattle, WA 98102-1621

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Apr 15, 2024 through Apr 15, 2028

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
LF61186433WAMDMarriage & Family Therapist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1540512000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1683417600000",
    "number": "1215404397",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2366 EASTLAKE AVENUE EAST #402",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981021621"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2366 EASTLAKE AVENUE EAST #402",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981021621",
            "telephone_number": "360-329-2003"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NELSEN-BARBOSA",
        "first_name": "EMERY",
        "middle_name": "KILLIAN",
        "credential": "LMFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-10-26",
        "last_updated": "2023-05-07",
        "certification_date": "2023-05-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "WA",
            "license": "LF61186433",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Seattle, WA

Sources for this page

Verify at the official NPI Registry.