Kellyn McCullough, MHP., LMFT

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

LF60705572 Issued in WA

Practice address

640 NW Gilman Blvd Ste 101
Issaquah, WA 98027-2476

Phone

(650) 866-5139

NPI assigned

Dec 7, 2016

Last updated

Sep 22, 2025By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Previously, effective Aug 20, 2024 through Aug 20, 2026

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1481068800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1758499200000",
    "number": "1366986580",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "640 NW GILMAN BLVD STE 101",
            "city": "ISSAQUAH",
            "state": "WA",
            "postal_code": "980272476",
            "telephone_number": "650-866-5139"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "640 NW GILMAN BLVD STE 101",
            "city": "ISSAQUAH",
            "state": "WA",
            "postal_code": "980272476",
            "telephone_number": "650-866-5139"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCULLOUGH",
        "first_name": "KELLYN",
        "credential": "MHP., LMFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-12-07",
        "last_updated": "2025-09-22",
        "certification_date": "2025-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "WA",
            "license": "LF60705572",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ryoko Miyagi McConkie
• Abigail McCormack, DPT
• Kelly M McCormick, R.PH.
• Alexandra McCreary, MA
• Malena Marie McCrone, LMP
• Michael McDonald
• Alicia Christine McElroy, L.M.P.
• Merissa Jean McEwan
• Lindsey Nicole McFerran, MSW, LSWAA
• Janeen McGuire Nelson, MFT

• Marriage & Family Therapist in Issaquah, WA
• Providers in Issaquah, WA by specialty
• Marriage & Family Therapist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.