Individual provider Active NPI

Kelly Kerby, LMHC, CDP

  • Mental Health Counselor
  • Seattle, WA
National Provider Identifier
1629219167
Registry record updated Mar 12, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
LH00010973 Issued in WA
Practice address
2400 NE 95TH St
Seattle, WA 98115-2426
Phone
(206) 525-5050
Fax
(206) 525-9795
NPI assigned
Mar 12, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 12, 2009

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X CP00006207 WA
Mental Health Counselor 101YM0800X LH00010973 WA Primary

Addresses

Primary practice location

2400 NE 95TH St
Seattle, WA 98115-2426

Mailing address

2400 NE 95TH St
Seattle, WA 98115-2426
Phone (206) 525-5050

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
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.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240624001572 WA Practitioner - Mental Health Counselor 7113460742 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CP00006207WAMDAddiction (Substance Use Disorder) Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Seattle Children'S Hospital Current Accepting new patients
Seattle Children'S Hospital CurrentSince May 12, 2024 Accepting new patients
Seattle Childrens Hospital CurrentSince May 12, 2024 Accepting new patients

Locations

1035 116th Ave NE
Bellevue, WA 98004
Phone (425) 451-4141

8232 W Grandridge Blvd
Kennewick, WA 99336
Phone (509) 582-1700

4800 Sand Point Way NE
Seattle, WA 98105
Phone (206) 526-2000

1780 NW Myhre Rd
Ste 2120
Silverdale, WA 98383
Phone (360) 782-3100

Organizations & group practices 3

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": "1236816000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1236816000000",
    "number": "1629219167",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2400 NE 95TH ST",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981152426",
            "telephone_number": "206-525-5050",
            "fax_number": "206-525-9795"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2400 NE 95TH ST",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981152426",
            "telephone_number": "206-525-5050",
            "fax_number": "206-525-9795"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KERBY",
        "first_name": "KELLY",
        "credential": "LMHC, CDP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-03-12",
        "last_updated": "2009-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "WA",
            "license": "CP00006207",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WA",
            "license": "LH00010973",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Seattle, WA

Sources for this page

Verify at the official NPI Registry.