Individual provider Active NPI

Kelly Nutting, LMFT

  • Marriage & Family Therapist
  • Yakima, WA
National Provider Identifier
1932605482
Registry record updated Sep 23, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
LF61172000 Issued in WA
Practice address
11 N 11TH Ave Ste 108
Yakima, WA 98902-3085
Phone
(916) 214-3996
NPI assigned
Apr 3, 2018
Last updated
Sep 23, 2021By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 23, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X LF61172000 WA Primary

Addresses

Primary practice location

11 N 11TH Ave Ste 108
Yakima, WA 98902-3085

Mailing address

221 S 25TH Ave
Yakima, WA 98902-3704
Phone (916) 214-3996

Other identifiers 1

IdentifierTypeStateIssuer
2100847MedicaidWA

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
LF61172000WAMDMarriage & Family Therapist

NPI Registry JSON

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

{
    "created_epoch": "1522713600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632355200000",
    "number": "1932605482",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "221 S 25TH AVE",
            "city": "YAKIMA",
            "state": "WA",
            "postal_code": "989023704",
            "telephone_number": "916-214-3996"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11 N 11TH AVE STE 108",
            "city": "YAKIMA",
            "state": "WA",
            "postal_code": "989023085",
            "telephone_number": "916-214-3996"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NUTTING",
        "first_name": "KELLY",
        "credential": "LMFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-04-03",
        "last_updated": "2021-09-23",
        "certification_date": "2021-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "WA",
            "license": "LF61172000",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2100847",
            "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 Sep 23, 2021; 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.