Individual provider Active NPI

Heidi Marie Kinsella, LMHCA

  • Mental Health Counselor
  • Seattle, WA
National Provider Identifier
1407286602
Registry record updated Jun 26, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
LH60535761 Issued in WA
Practice address
1800 Westlake Ave N Ste 105
Seattle, WA 98109-2782
Phone
(425) 652-1690
NPI assigned
Nov 25, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 26, 2019

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X CP60721364 WA
Mental Health Counselor 101YM0800X PC131270 AK
Mental Health Counselor 101YM0800X MHC577 HI
Mental Health Counselor 101YM0800X LH60535761 WA Primary

Addresses

Primary practice location

1800 Westlake Ave N Ste 105
Seattle, WA 98109-2782

Mailing address

2370 130TH Ave NE Ste 104
Bellevue, WA 98005-1770
Phone (425) 628-2820

Medicare participation

Medicare enrollment files
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
Yes, effective Jun 26, 2024 through Jun 26, 2028

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
CP60721364WAMDAddiction (Substance Use Disorder) Counselor
PC131270AKMDMental Health Counselor
MHC577HIMDMental Health Counselor
LH60535761WAMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Fourth Dimension Counseling, Inc. CurrentSince Jul 25, 2021 Accepting new patients
Pacific Behavioral Healthcare Mental Health Past Accepting new patients

Locations

472 Front St N
Ste A
Issaquah, WA 98027
Phone (425) 652-1690

Organizations & group practices 2

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": "1385337600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1561507200000",
    "number": "1407286602",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2370 130TH AVE NE STE 104",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980051770",
            "telephone_number": "425-628-2820"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1800 WESTLAKE AVE N STE 105",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981092782",
            "telephone_number": "425-652-1690"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KINSELLA",
        "first_name": "HEIDI",
        "middle_name": "MARIE",
        "credential": "LMHCA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-11-25",
        "last_updated": "2019-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "WA",
            "license": "CP60721364",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "AK",
            "license": "PC131270",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "HI",
            "license": "MHC577",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WA",
            "license": "LH60535761",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Seattle, WA

Sources for this page

Verify at the official NPI Registry.