Active NPI
Karyn L Ellis, LMCA, MHP
- Mental Health Counselor
- Lynnwood, WA
National Provider Identifier
1841532066
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- MC60220294
- Practice address
- 4807 196TH St SW
Ste 100
Lynnwood, WA 98036-6430 - Phone
- (425) 774-4269
- NPI assigned
- Mar 26, 2013
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | MC60220294 | WA | Primary |
Addresses
Primary practice location
4807 196TH St SW
Ste 100
Lynnwood, WA 98036-6430
Mailing address
4807 196TH St SW
Ste 100
Lynnwood, WA 98036-6430
Phone (425) 774-4269
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
| License | State | Type | Specialty |
|---|---|---|---|
| MC60220294 | WA | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1364256000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1364256000000",
"number": "1841532066",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4807 196TH ST SW",
"address_2": "STE 100",
"city": "LYNNWOOD",
"state": "WA",
"postal_code": "980366430",
"telephone_number": "425-774-4269"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4807 196TH ST SW",
"address_2": "STE 100",
"city": "LYNNWOOD",
"state": "WA",
"postal_code": "980366430",
"telephone_number": "425-774-4269"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ELLIS",
"first_name": "KARYN",
"middle_name": "L",
"credential": "LMCA, MHP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-03-26",
"last_updated": "2013-03-26",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "WA",
"license": "MC60220294",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lynnwood, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.