Healthcare Provider Details

I. General information

NPI: 1003221011
Provider Name (Legal Business Name): KEVIN SOSA LMHC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/27/2014
Last Update Date: 10/08/2026
Certification Date: 10/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

25029 144TH PL SE
KENT WA
98042-3425
US

IV. Provider business mailing address

25029 144TH PL SE
KENT WA
98042-3425
US

V. Phone/Fax

Practice location:
  • Phone: 650-922-3049
  • Fax:
Mailing address:
  • Phone: 253-642-6127
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberMHC.LH.70121196
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: