Kelly Merrill, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

LW61336082 Issued in WA

Practice address

33442 1St Way S Ste 104
Federal Way, WA 98003-6210

Phone

(253) 691-8694

NPI assigned

Dec 6, 2024

Last updated

Sep 30, 2025By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1733443200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759190400000",
    "number": "1700692506",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "33442 1ST WAY S STE 104",
            "city": "FEDERAL WAY",
            "state": "WA",
            "postal_code": "980036210",
            "telephone_number": "253-691-8694"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "33442 1ST WAY S STE 104",
            "city": "FEDERAL WAY",
            "state": "WA",
            "postal_code": "980036210",
            "telephone_number": "253-691-8694"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MERRILL",
        "first_name": "KELLY",
        "credential": "LICSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-12-06",
        "last_updated": "2025-09-30",
        "certification_date": "2025-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WA",
            "license": "LW61336082",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jackeline Andrea Mencos-Cante
• Jose Antonio Mendoza, MD
• Kelemwa H Menegesha
• Sara Merbach
• Megan Merrick, LMP
• Megan C Merritt, PA-C
• Ryan Michael Merritt, DO
• Matthew T Messerschmidt, MD
• Kristen Meyer
• MH Wellness & Acupuncture Studio

• Clinical Social Worker in Federal Way, WA
• Providers in Federal Way, WA by specialty
• Clinical Social Worker in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2025; 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.