Healthcare Provider Details

I. General information

NPI: 1679930036
Provider Name (Legal Business Name): KEVIN TODD LMHC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/15/2016
Last Update Date: 06/02/2026
Certification Date: 06/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7014 W OKANOGAN PL
KENNEWICK WA
99336-5076
US

IV. Provider business mailing address

7014 W OKANOGAN PL
KENNEWICK WA
99336-5076
US

V. Phone/Fax

Practice location:
  • Phone: 509-792-0039
  • Fax: 509-416-2033
Mailing address:
  • Phone: 509-792-0039
  • Fax: 509-416-2033

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: