Healthcare Provider Details

I. General information

NPI: 1548127541
Provider Name (Legal Business Name): PAYAL KANSAL LMHCA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/09/2026
Last Update Date: 01/09/2026
Certification Date: 01/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18912 N CREEK PKWY STE 208
BOTHELL WA
98011-8016
US

IV. Provider business mailing address

26628 NE 143RD PL
DUVALL WA
98019-8678
US

V. Phone/Fax

Practice location:
  • Phone: 425-666-2943
  • Fax:
Mailing address:
  • Phone: 425-306-3897
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberMHCA.MC.70031642
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: