Kellie Rae Ketchum

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

MHCA.MC.70176135 Issued in WA

Practice address

1015 S 40TH Ave Ste 18
Yakima, WA 98908-3867

Phone

(509) 367-6130

NPI assigned

Sep 24, 2026

Last updated

Sep 24, 2026By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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

{
    "created_epoch": "1790208000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1790208000000",
    "number": "1972416535",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1015 S 40TH AVE STE 18",
            "city": "YAKIMA",
            "state": "WA",
            "postal_code": "989083867",
            "telephone_number": "509-367-6130"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1015 S 40TH AVE STE 18",
            "city": "YAKIMA",
            "state": "WA",
            "postal_code": "989083867",
            "telephone_number": "509-367-6130"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KETCHUM",
        "first_name": "KELLIE",
        "middle_name": "RAE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-09-24",
        "last_updated": "2026-09-24",
        "certification_date": "2026-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WA",
            "license": "MHCA.MC.70176135",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Mental Health Counselor in Yakima, WA
• Providers in Yakima, WA by specialty
• Mental Health Counselor in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.

Verify at the official NPI Registry.