Individual provider Active NPI

Talia Kuykendall, MA, LMHC, CDP

  • Mental Health Counselor
  • Federal Way, WA
National Provider Identifier
1679018436
Registry record updated Dec 16, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
LH61025085 Issued in WA
Practice address
3430 SW 320TH St
Federal Way, WA 98023-2292
Phone
(253) 289-6099
Fax
(253) 231-7251
NPI assigned
Jan 3, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 16, 2020

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 CP60297550 WA
Mental Health Counselor 101YM0800X LH61025085 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
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
I20240311003841 WA Practitioner - Mental Health Counselor 0941646095 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2017
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services
Group practices
Twin Lakes Counseling, PLLCGroup PAC ID 3375988298, 8 clinicians

Practice addresses (Care Compare)

3430 SW 320TH St
Suite D2
Federal Way, WA 98023-2292
Phone (253) 289-6099

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
CP60297550WAMDAddiction (Substance Use Disorder) Counselor
LH61025085WAMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Twin Lakes Counseling, PLLC Addiction (Substance Use Disorder) CurrentSince Feb 27, 2024 Accepting new patients
Sound Past Accepting new patients

Locations

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

3430 SW 320th St
Ste D2
Federal Way, WA 98023
Phone (253) 289-6099

Organizations & group practices 2

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": "1483401600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1608076800000",
    "number": "1679018436",
    "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",
            "fax_number": "253-231-7251"
        },
        {
            "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",
            "fax_number": "253-231-7251"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUYKENDALL",
        "first_name": "TALIA",
        "credential": "MA, LMHC, CDP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-01-03",
        "last_updated": "2020-12-16",
        "certification_date": "2020-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "WA",
            "license": "CP60297550",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WA",
            "license": "LH61025085",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Federal Way, WA

Sources for this page

Verify at the official NPI Registry.