Individual provider Active NPI

Keziah Mayers, LMHCA, RBT

  • Mental Health Counselor
  • Spokane, WA
National Provider Identifier
1639632698
Registry record updated Jul 20, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
MC61187444 Issued in WA
Practice address
1616 W Wellesley Ave Ste B
Spokane, WA 99205-1413
Phone
(509) 844-9336
NPI assigned
Apr 8, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 20, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior TechnicianGroup: 193400000X SINGLE SPECIALTY GROUP 106S00000X CB60918710 WA
Mental Health CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101YM0800X MC61187444 WA Primary

Addresses

Primary practice location

1616 W Wellesley Ave Ste B
Spokane, WA 99205-1413

Mailing address

1616 W Wellesley Ave Ste B
Spokane, WA 99205-1413

Other identifiers 1

IdentifierTypeStateIssuer
CB60918710OtherWALICENSE

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
MC61187444WAMDMental Health Counselor
CB60918710WAMDBehavior Technician

NPI Registry JSON

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

{
    "created_epoch": "1554681600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626739200000",
    "number": "1639632698",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1616 W WELLESLEY AVE STE B",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992051413"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1616 W WELLESLEY AVE STE B",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992051413",
            "telephone_number": "509-844-9336"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAYERS",
        "first_name": "KEZIAH",
        "name_prefix": "Miss",
        "credential": "LMHCA, RBT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-04-08",
        "last_updated": "2021-07-20",
        "certification_date": "2021-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Behavior Technician",
            "state": "WA",
            "license": "CB60918710",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": "WA",
            "license": "MC61187444",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "CB60918710",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Spokane, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2021; 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.