Active NPI
Kaya Wynn O'Connor, MSW, LICSW
- Clinical Social Worker
- Mercer Island, WA
National Provider Identifier
1346797172
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- LW61374691
- Practice address
- 8015 SE 28TH Street
Suite 309
Mercer Island, WA 98040 - Phone
- (206) 444-3600
- Fax
- (206) 444-3610
- NPI assigned
- Sep 9, 2016
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | LW61374691 | WA | Primary |
| Student in an Organized Health Care Education/Training Program | 390200000X |
Addresses
Primary practice location
8015 SE 28TH Street
Suite 309
Mercer Island, WA 98040
Mailing address
8015 SE 28TH Street
Suite 309
Mercer Island, WA 98040
Phone (206) 651-4729
Other names 1
- Ms. Kaya Elizabeth Wynn
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Mar 20, 2025 through Mar 20, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LW61374691 | WA | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1473379200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1768435200000",
"number": "1346797172",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8015 SE 28TH STREET",
"address_2": "SUITE 309",
"city": "MERCER ISLAND",
"state": "WA",
"postal_code": "98040",
"telephone_number": "206-651-4729",
"fax_number": "206-302-2210"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8015 SE 28TH STREET",
"address_2": "SUITE 309",
"city": "MERCER ISLAND",
"state": "WA",
"postal_code": "98040",
"telephone_number": "206-444-3600",
"fax_number": "206-444-3610"
}
],
"practiceLocations": [],
"basic": {
"last_name": "O'CONNOR",
"first_name": "KAYA",
"middle_name": "WYNN",
"name_prefix": "Mrs.",
"credential": "MSW, LICSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2016-09-09",
"last_updated": "2026-01-15",
"certification_date": "2026-01-15",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "WA",
"license": "LW61374691",
"primary": true
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "KAYA",
"last_name": "WYNN",
"middle_name": "ELIZABETH",
"prefix": "MS.",
"credential": "MSW, LICSW",
"code": "2",
"type": "Professional Name"
}
]
}Other providers in Mercer Island, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2026; 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.