Kassondra Lynn Wilson

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Practice address

201 S Locust St
Ellensburg, WA 98926-9006

Phone

(206) 892-8325

Fax

(844) 848-7543

NPI assigned

Nov 18, 2015

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

Opted out of Medicare

Yes, effective May 28, 2025 through May 28, 2027

Medicare enrollment (NPD)

Not enrolled

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.

• Seattle Counseling Center

  • Community/Behavioral Health Agency
  • Seattle, WA
  • NPI 1396958302
  NPD (past)

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

{
    "created_epoch": "1447804800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675036800000",
    "number": "1427422153",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 S LOCUST ST",
            "city": "ELLENSBURG",
            "state": "WA",
            "postal_code": "989269006",
            "telephone_number": "206-892-8325",
            "fax_number": "844-848-7543"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 S LOCUST ST",
            "city": "ELLENSBURG",
            "state": "WA",
            "postal_code": "989269006",
            "telephone_number": "206-892-8325",
            "fax_number": "844-848-7543"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "KASSONDRA",
        "middle_name": "LYNN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-11-18",
        "last_updated": "2023-01-30",
        "certification_date": "2023-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Whole Health Pharmacy LLC
• Fritz William Wichterman
• James R Wickerath, M.D.
• Kaitlyn Wilder
• Brian T. Williams, C.P.O., L.P.O.
• Elizabeth F Wise, MD
• Scott Wise, HA 61364303
• Seth Wiswell
• Stacey Wolfe
• Paul David Wood, PA-C

• Mental Health Counselor in Ellensburg, WA
• Providers in Ellensburg, 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 Jan 30, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.