Individual provider Active NPI

Brian O Kimmel

  • Mental Health Counselor
  • Seattle, WA
National Provider Identifier
1861902850
Registry record updated Sep 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
LH60993754 Issued in WA
Practice address
3417 Evanston Ave N Ste 322
Seattle, WA 98103-8968
Phone
(425) 272-5585
NPI assigned
Oct 4, 2017
Last updated
Sep 24, 2024By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 24, 2024

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101Y00000X LH60993754 WA
Health & Wellness Coach 171400000X
Dance TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225600000X
Mental Health CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YM0800X LH60993754 WA Primary

Addresses

Primary practice location

3417 Evanston Ave N Ste 322
Seattle, WA 98103-8968

Mailing address

3417 Evanston Ave N Ste 322
Seattle, WA 98103-8968
Phone (425) 272-5585

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
LH60993754WAMDCounselor

Practice roles

OrganizationSpecialtyStatusNew patients
Art Love Legacies, LLC Counselor Current Accepting new patients

Locations

3417 Evanston Ave N
Ste 322
Seattle, WA 98103
Phone (206) 257-9583

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1507075200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727136000000",
    "number": "1861902850",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3417 EVANSTON AVE N STE 322",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981038968",
            "telephone_number": "425-272-5585"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3417 EVANSTON AVE N STE 322",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981038968",
            "telephone_number": "425-272-5585"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIMMEL",
        "first_name": "BRIAN",
        "middle_name": "O",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-10-04",
        "last_updated": "2024-09-24",
        "certification_date": "2024-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor",
            "state": "WA",
            "license": "LH60993754",
            "primary": false
        },
        {
            "code": "171400000X",
            "taxonomy_group": "",
            "desc": "Health & Wellness Coach",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225600000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dance Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": "WA",
            "license": "LH60993754",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Seattle, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 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.