Individual provider Active NPI

Tracie Lynn Carlson, LMHC

  • Mental Health Counselor
  • Kirkland, WA
National Provider Identifier
1679646525
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
LH00008574 Issued in WA
Practice address
13115 121St Way NE Ste C
Kirkland, WA 98034-3051
Phone
(425) 821-1800
Fax
(425) 821-1818
NPI assigned
Nov 16, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X LH00008574 WA Primary

Addresses

Primary practice location

13115 121St Way NE Ste C
Kirkland, WA 98034-3051

Mailing address

13115 121St Way NE Ste C
Kirkland, WA 98034-3051
Phone (425) 821-1800

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
LH00008574WAMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1163635200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1679646525",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13115 121ST WAY NE STE C",
            "city": "KIRKLAND",
            "state": "WA",
            "postal_code": "980343051",
            "telephone_number": "425-821-1800",
            "fax_number": "425-821-1818"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13115 121ST WAY NE STE C",
            "city": "KIRKLAND",
            "state": "WA",
            "postal_code": "980343051",
            "telephone_number": "425-821-1800",
            "fax_number": "425-821-1818"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARLSON",
        "first_name": "TRACIE",
        "middle_name": "LYNN",
        "credential": "LMHC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-16",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WA",
            "license": "LH00008574",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kirkland, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.