Active NPI
Kelsey B Hawk, M.A.
- Mental Health Counselor
- Yakima, WA
National Provider Identifier
1881997492
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- MC60129038
- Practice address
- 412 S 12TH Ave
Yakima, WA 98902-3115 - Phone
- (509) 308-1307
- NPI assigned
- Dec 21, 2010
- 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 | MC60129038 | WA | Primary |
Addresses
Primary practice location
412 S 12TH Ave
Yakima, WA 98902-3115
Mailing address
412 S 12TH Ave
Yakima, WA 98902-3115
Phone (509) 308-1307
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| MC60129038 | Other | WA | WA STATE DOH |
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)
- Enrolled
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MC60129038 | WA | MD | Mental Health Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Marvin Behavioral Health Ma PC | Mental Health | Past | Accepting new patients |
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 and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1292889600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1292889600000",
"number": "1881997492",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "412 S 12TH AVE",
"city": "YAKIMA",
"state": "WA",
"postal_code": "989023115",
"telephone_number": "509-308-1307"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "412 S 12TH AVE",
"city": "YAKIMA",
"state": "WA",
"postal_code": "989023115",
"telephone_number": "509-308-1307"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HAWK",
"first_name": "KELSEY",
"middle_name": "B",
"credential": "M.A.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-12-21",
"last_updated": "2010-12-21",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "WA",
"license": "MC60129038",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "WA STATE DOH",
"identifier": "MC60129038",
"state": "WA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Yakima, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.