Active NPI
Destini Kirkwood, LMHCA, AAC
- Professional Counselor
- Long Beach, WA
National Provider Identifier
1407355902
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- MHC.LH.61012462
- Practice address
- 2204 Pacific Ave N
Long Beach, WA 98631-3300 - Phone
- (360) 642-2096
- Fax
- (360) 642-2096
- NPI assigned
- Feb 9, 2018
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | CG60521009 | WA | |
| Mental Health Counselor | 101YM0800X | MC60820574 | WA | |
| Professional Counselor | 101YP2500X | MHC.LH.61012462 | WA | Primary |
Addresses
Primary practice location
2204 Pacific Ave N
Long Beach, WA 98631-3300
Mailing address
2204 Pacific Ave N
Long Beach, WA 98631-3300
Phone (360) 642-2096
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
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| CG60521009 | WA | MD | Mental Health Counselor |
| MC60820574 | WA | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1518134400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1786406400000",
"number": "1407355902",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2204 PACIFIC AVE N",
"city": "LONG BEACH",
"state": "WA",
"postal_code": "986313300",
"telephone_number": "360-642-2096",
"fax_number": "360-642-2096"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2204 PACIFIC AVE N",
"city": "LONG BEACH",
"state": "WA",
"postal_code": "986313300",
"telephone_number": "360-642-2096",
"fax_number": "360-642-2096"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KIRKWOOD",
"first_name": "DESTINI",
"credential": "LMHCA, AAC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-02-09",
"last_updated": "2026-08-11",
"certification_date": "2026-08-11",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "WA",
"license": "CG60521009",
"primary": false
},
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "WA",
"license": "MC60820574",
"primary": false
},
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "WA",
"license": "MHC.LH.61012462",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Long Beach, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2026; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.