Active NPI
Serena Faith Konkin, MA
- Marriage & Family Therapist
- Redmond, WA
National Provider Identifier
1689924441
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- MG60479640
- Practice address
- 16150 NE 85TH St Ste 121
Redmond, WA 98052-3542 - Phone
- (505) 917-0525
- NPI assigned
- Sep 19, 2012
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Marriage & Family Therapist | 106H00000X | MG60479640 | WA | Primary |
| Marriage & Family Therapist | 106H00000X | 118113 | CA |
Addresses
Primary practice location
16150 NE 85TH St Ste 121
Redmond, WA 98052-3542
Mailing address
7741 21St Ave NW
Seattle, WA 98117-4311
Phone (505) 917-0525
Other practice location 1
1600 East Olive Street
Sound Mental Health
Seattle, WA 98122
Phone (206) 302-2200
Other practice location 2
113 E F St
Tehachapi, CA 93561-1710
Phone (661) 822-8223
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
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 118113 | CA | MD | Marriage & Family Therapist |
| MG60479640 | WA | MD | Marriage & Family Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1348012800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1620777600000",
"number": "1689924441",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7741 21ST AVE NW",
"city": "SEATTLE",
"state": "WA",
"postal_code": "981174311",
"telephone_number": "505-917-0525"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "16150 NE 85TH ST STE 121",
"city": "REDMOND",
"state": "WA",
"postal_code": "980523542",
"telephone_number": "505-917-0525"
}
],
"practiceLocations": [
{
"address_1": "1600 East Olive Street",
"address_2": "Sound Mental Health",
"address_purpose": "LOCATION",
"city": "Seattle",
"state": "WA",
"postal_code": "98122",
"country_code": "US",
"telephone_number": "206-302-2200",
"fax_number": "206-302-2210",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "113 E F St",
"address_purpose": "LOCATION",
"city": "Tehachapi",
"state": "CA",
"postal_code": "935611710",
"country_code": "US",
"telephone_number": "661-822-8223",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "KONKIN",
"first_name": "SERENA",
"middle_name": "FAITH",
"credential": "MA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-09-19",
"last_updated": "2021-05-12",
"certification_date": "2021-04-14",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "WA",
"license": "MG60479640",
"primary": true
},
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "CA",
"license": "118113",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Redmond, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 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.