Kahlia Ani Nydam

Primary specialty

CounselorTaxonomy code 101Y00000X

License

VENTUKA094R9 Issued in WA

Practice address

6221 NE Fourth Plain Blvd Ste a
Vancouver, WA 98661-7206

Phone

(360) 449-2557

NPI assigned

Mar 5, 2020

Last updated

Feb 22, 2024By 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

Other names 1

• Kahlia Ani Ventura Former name

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": "1583366400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708560000000",
    "number": "1740815190",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 34703",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981241703",
            "telephone_number": "206-764-0502",
            "fax_number": "206-764-0516"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6221 NE FOURTH PLAIN BLVD STE A",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986617206",
            "telephone_number": "360-449-2557"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NYDAM",
        "first_name": "KAHLIA",
        "middle_name": "ANI",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-03-05",
        "last_updated": "2024-02-22",
        "certification_date": "2024-02-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "WA",
            "license": "VENTUKA094R9",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KAHLIA",
            "last_name": "VENTURA",
            "middle_name": "ANI",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Counselor in Vancouver, WA
• Providers in Vancouver, WA by specialty
• Counselor in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 2024; 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.