Individual provider Active NPI

Ashley Nicole-Kirley Nelson, LMFT

  • Marriage & Family Therapist
  • Olympia, WA
National Provider Identifier
1366808156
Registry record updated Apr 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
LF60795314 Issued in WA
Practice address
908 5TH Ave SE
Olympia, WA 98501-1507
Phone
(360) 754-2423
NPI assigned
Jan 8, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 16, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X MG60606139 WA
Marriage & Family Therapist 106H00000X LF60795314 WA Primary

Addresses

Primary practice location

908 5TH Ave SE
Olympia, WA 98501-1507

Mailing address

711 State Ave NE
Olympia, WA 98506-3984
Phone (360) 972-6947

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
I20240121000100 WA Practitioner - Marriage and Family Therapist 9436501947 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
MG60606139WAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Telecare Mental Health Services of Washington, Inc. CurrentSince Jan 1, 2024 Accepting new patients
Telecare Mental Health Services of Washington, Inc Current Accepting new patients
Telecare Mental Health Services of Washington Inc CurrentSince Jan 1, 2024 Accepting new patients

Locations

1080 Marina Village Pkwy
Ste 100
Alameda, CA 94501
Phone (510) 306-5660

908 5th Ave SE
Olympia, WA 98501
Phone (360) 754-2423

601 W Franklin St
Ste B
Shelton, WA 98584
Phone (360) 462-3016

9601 Steilacoom Blvd SW
Bldg 27
Tacoma, WA 98498
Phone (253) 589-5334

Organizations & group practices 3

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": "1452211200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713225600000",
    "number": "1366808156",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "711 STATE AVE NE",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "985063984",
            "telephone_number": "360-972-6947"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "908 5TH AVE SE",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "985011507",
            "telephone_number": "360-754-2423"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NELSON",
        "first_name": "ASHLEY",
        "middle_name": "NICOLE-KIRLEY",
        "credential": "LMFT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-01-08",
        "last_updated": "2024-04-16",
        "certification_date": "2022-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "WA",
            "license": "MG60606139",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "WA",
            "license": "LF60795314",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Olympia, WA

Sources for this page

Verify at the official NPI Registry.