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Deactivated NPI 1114471877 Deactivated / Inactive NPI Female Practitioner

Kelly Templer

Counselor • Shoreline, WA

⚠️

Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Kelly Templer has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date August 11, 2016
NPI Deactivation Date September 16, 2021
Total Practice Duration ~5 Years of Practice (2016 – 2021)

Professional Overview & Biography Verified Profile Summary

Kelly Templer was a registered Counselor practicing in Shoreline, WA. Throughout an active medical career spanning 5 years, Kelly Templer provided care at the practice location at 16715 AURORA AVE N until profile deactivation on 2021-09-16.

Practice Location & Contact Primary Location

Practice Address

16715 Aurora Ave N

Shoreline, WA 981335310

Telephone 2065469766
Fax 2065420326
Associated Practice Facility / Clinic
🏢 Therapeutic Health Services Facility NPI 1881206886

Specialty Benchmarks & Practice Insights

Comparative analytics for Counselor in Shoreline, WA

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 13.0 Yrs
Regional Practice Density
90 Specialists

Practicing in Shoreline, WA (11556 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

CMS Verified: 2023-03-10
Counselor Primary Specialty

NUCC Taxonomy Code: 101Y00000X

A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master's degree and clinical experience and supervision for licensure or certification.

Social Worker

NUCC Taxonomy Code: 104100000X

State License MI 6802089029

A social worker is a person who is qualified by a Social Work degree, and licensed, certified or registered by the state as a social worker to practice within the scope of that license. A social worker provides assistance and counseling to clients and their families who are dealing with social, emotional and environmental problems. Social work services may be rendered to individuals, families, groups, and the public.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

40 Associated Practitioners
Sonya Girtman

Counselor - Addiction (Substance Use Disorder)

NPI 1023468964
Andrea Arany-Kovacs , SUDP

Counselor - Addiction (Substance Use Disorder)

NPI 1043824899
Toni Santoro

Counselor - Addiction (Substance Use Disorder)

NPI 1043909658
Kimberly Olatawura , SUDPT

Counselor - Addiction (Substance Use Disorder)

NPI 1063124758
Menbere Kifle

Counselor

NPI 1063769750
Benjamin Ross , BS, CDP

Counselor - Addiction (Substance Use Disorder)

NPI 1063788511

Bachelor of Science, CDP

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

17 Historical Events
📍
Updated Practice Location March 10, 2023

Registered at 16715 AURORA AVE N, SHORELINE, WA 981335310 (Tel: 2065469766)

📍
Updated Business Mailing Address March 10, 2023

Registered at 16715 AURORA AVE N, SHORELINE, WA 981335310 (Tel: 2065469766)

👤
Provider Name / Credentials Updated March 10, 2023

Recorded as KELLY TEMPLER

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) March 10, 2023

Social Worker (License #6802089029 in MI)

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NPI Profile Deactivated September 16, 2021

Record deactivated on September 16, 2021

📍
Updated Practice Location January 21, 2021

Registered at 16715 AURORA AVE N, SHORELINE, WA 981335310 (Tel: 2065469766)

📍
Updated Business Mailing Address January 21, 2021

Registered at 16715 AURORA AVE N, SHORELINE, WA 981335310 (Tel: 2065469766)

👤
Provider Name / Credentials Updated January 21, 2021

Recorded as KELLY TEMPLER

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) January 21, 2021

Counselor

📍
Updated Practice Location May 24, 2018

Registered at 1939 S DIVISION AVE., GRAND RAPIDS, MI 49507 (Tel: 6162473815)

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Updated Business Mailing Address May 24, 2018

Registered at 1939 S DIVISION AVE., GRAND RAPIDS, MI 49507 (Tel: 6162473815)

NPI Profile Active August 11, 2016

NPI status registered as active in NPPES database

📍
Updated Practice Location August 11, 2016

Registered at 4255 KALAMAZOO AVE SE, GRAND RAPIDS, MI 495083638 (Tel: 6164550960)

📍
Updated Business Mailing Address August 11, 2016

Registered at 4255 KALAMAZOO AVE SE, GRAND RAPIDS, MI 495083638 (Tel: 6164550960)

👤
Provider Name / Credentials Updated August 11, 2016

Recorded as KELLY BOTH

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) August 11, 2016

Social Worker (License #6802089029 in MI)

🟢
Initial NPI Registration & Enumeration August 11, 2016

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1114471877
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: August 11, 2016
Last Update: March 10, 2023
Deactivation Date: September 16, 2021
Sole Proprietor: No

Mailing Address

16715 Aurora Ave N

Shoreline, WA 981335310

Phone: 2065469766

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.