Krystal Maya Khemkaran-Lopez

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

MC61656392 Issued in WA

Practice address

6505 216TH St SW Ste 100
Mountlake Terrace, WA 98043-2089

Phone

(425) 678-6463

NPI assigned

Jun 25, 2018

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Project Brilliance

  • Behavior Analyst
  • Palm Beach Gardens, FL
  • NPI 1760889117
  NPD (past)

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

{
    "created_epoch": "1529884800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747180800000",
    "number": "1366937088",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 N HOWARD ST STE W",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992010508"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6505 216TH ST SW STE 100",
            "city": "MOUNTLAKE TERRACE",
            "state": "WA",
            "postal_code": "980432089",
            "telephone_number": "425-678-6463"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2979 Pga Blvd # 200",
            "address_purpose": "LOCATION",
            "city": "Palm Beach Gardens",
            "state": "FL",
            "postal_code": "33410",
            "country_code": "US",
            "telephone_number": "561-260-5900",
            "fax_number": "561-513-8211",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2979 Pga Blvd # 200",
            "address_purpose": "LOCATION",
            "city": "Palm Beach Gardens",
            "state": "FL",
            "postal_code": "33410",
            "country_code": "US",
            "telephone_number": "561-260-5900",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2979 Pga Blvd # 200",
            "address_purpose": "LOCATION",
            "city": "Palm Beach Gardens",
            "state": "FL",
            "postal_code": "334102911",
            "country_code": "US",
            "telephone_number": "561-260-5900",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "9000 Burma Rd Ste 109",
            "address_purpose": "LOCATION",
            "city": "Palm Beach Gardens",
            "state": "FL",
            "postal_code": "334031606",
            "country_code": "US",
            "telephone_number": "561-508-6122",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "9000 Burma Rd Ste 109",
            "address_purpose": "LOCATION",
            "city": "Palm Beach Gardens",
            "state": "FL",
            "postal_code": "334031606",
            "country_code": "US",
            "telephone_number": "561-508-6122",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KHEMKARAN-LOPEZ",
        "first_name": "KRYSTAL",
        "middle_name": "MAYA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-06-25",
        "last_updated": "2025-05-14",
        "certification_date": "2025-05-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WA",
            "license": "MC61656392",
            "primary": true
        },
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Matthew Patrick Kelley, DDS
• Jeanne Kensler, LMP
• Alexandra Bethany Kerney
• Abdullah Khan I
• Christine Mesquita Khanna
• Toni Kibbee, LMP
• Kikalu PLLC
• Jennifer Kim
• Linda Kim, LD
• Sukho Kim, LICENSED DENTURIST

• Mental Health Counselor in Mountlake Terrace, WA
• Providers in Mountlake Terrace, WA by specialty
• Mental Health Counselor in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.