Individual provider Active NPI

Kelly Larson, LMFTA

  • Marriage & Family Therapist
  • Federal Way, WA
National Provider Identifier
1417829466
Registry record updated Dec 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
MG70040149 Issued in WA
Practice address
3430 SW 320TH St
Federal Way, WA 98023-2292
Phone
(253) 289-6099
NPI assigned
Sep 19, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 3, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X MG70040149 WA Primary

Addresses

Primary practice location

3430 SW 320TH St
Federal Way, WA 98023-2292

Mailing address

3430 SW 320TH St
Federal Way, WA 98023-2292
Phone (253) 289-6099

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
MG70040149WAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Twin Lakes Counseling, PLLC Marriage & Family Therapist CurrentSince Sep 21, 2025 Accepting new patients

Locations

3430 SW 320th St
Federal Way, WA 98023
Phone (253) 289-6099

Organizations & group practices 1

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": "1758240000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1764720000000",
    "number": "1417829466",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3430 SW 320TH ST",
            "city": "FEDERAL WAY",
            "state": "WA",
            "postal_code": "980232292",
            "telephone_number": "253-289-6099"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3430 SW 320TH ST",
            "city": "FEDERAL WAY",
            "state": "WA",
            "postal_code": "980232292",
            "telephone_number": "253-289-6099"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LARSON",
        "first_name": "KELLY",
        "credential": "LMFTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-09-19",
        "last_updated": "2025-12-03",
        "certification_date": "2025-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "WA",
            "license": "MG70040149",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Federal Way, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 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.