MEDICARE: THE PLAYFUL START LLC

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	103K00000X	Behavior Analyst

General Provider Information

NPI Number	:	1588502751
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	THE PLAYFUL START LLC

Provider Business Mailing Address
First Line	:	2022 18TH AVE SW
Second Line	:
City	:	OLYMPIA
State	:	WA
Zip	:	98502-4127
Country	:	US
Telephone Number	:	702-245-2692
Fax Number	:

Provider Business Practice Location Address
First Line	:	2022 18TH AVE SW
Second Line	:
City	:	OLYMPIA
State	:	WA
Zip	:	98502-4127
Country	:	US
Telephone Number	:	702-245-2692
Fax Number	:

Authorized Official
Title or Position	:	CLINICAL DIRECTOR, MEMBER
Name	:	MARISSA ASHLEY BARRETT KELLEHER
Credential	:	BCBA, LBA
Telephone Number	:	702-245-2692

Provider Enumeration Date	:	03/23/2026
Last Update Date	:	03/23/2026

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Directions to “THE PLAYFUL START LLC ” Practice Location

Language	Start Address	Practice Location

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