MEDICARE: MRS. KELSEY N OZMENT LMHC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor
2	101YP2500X	Professional Counselor	MC60321329	WA

General Provider Information

NPI Number	:	1114269354
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. KELSEY N OZMENT LMHC

Provider Business Mailing Address
First Line	:	103 E 3RD ST STE 203
Second Line	:
City	:	ARLINGTON
State	:	WA
Zip	:	98223-1348
Country	:	US
Telephone Number	:	253-332-9188
Fax Number	:

Provider Business Practice Location Address
First Line	:	103 E 3RD ST STE 203
Second Line	:
City	:	ARLINGTON
State	:	WA
Zip	:	98223-1348
Country	:	US
Telephone Number	:	253-332-9188
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/26/2013
Last Update Date	:	01/31/2020

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