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MICHELLE L KLEKOTA-CHISHOLM MA, LMHC
NPI 1740438779
Counselor - Mental Health in Lakewood, WA

Active since September 03, 2008Opted out of Medicare · through Jan 1, 2028
9311 BRIDGEPORT WAY SW, LAKEWOOD, WA 98499(253) 617-3559(253) 486-1916 Get Directions Write a Review

NPPES record last updated: May 16, 2018. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: May 16, 2018, Jan 6, 2017 (2 updates tracked since 2017).

About Michelle L Klekota-chisholm Ma, Lmhc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MICHELLE L KLEKOTA-CHISHOLM MA, LMHC (NPI 1740438779) is an individual mental health provider in Lakewood, Washington, licensed in Washington (LH 60231172) and active in the NPI registry since September 2008. She has opted out of Medicare through January 1, 2028.

NPPES Registry Identity

NPI1740438779
Entity TypeIndividualFemale
Primary Taxonomy101YM0800X
Provider Legal NameMICHELLE L KLEKOTA-CHISHOLMCredential: MA, LMHC
Location Address9311 BRIDGEPORT WAY SWLakewood, WA 98499
Mailing Address9311 Bridgeport Way SwLakewood, WA 98499-1570 · (253) 985-5090
Phone(253) 617-3559
Fax(253) 486-1916
Sole ProprietorNo
Enumeration DateSeptember 3, 2008
Last NPPES UpdateMay 16, 20182 updates tracked since enumeration
✔ NPI 1740438779 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · Mental HealthBehavioral Health & Social Service Providers
Taxonomy Code101YM0800X
Licenses✔ Licensed in WA · LH 60231172✔ Licensed in WA · RC00057820
9311 BRIDGEPORT WAY SW, Lakewood, WA 98499
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

ⓘ

Opted out of Medicare

Michelle L Klekota-chisholm Ma, Lmhc has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from January 1, 2024 through January 1, 2028.

Opt-Out Effective DateJanuary 1, 2024
Opt-Out In Effect ThroughJanuary 1, 2028Opt-out affidavits renew automatically every two years unless cancelled

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MS. ALISSA CHRISTINE MCCLELLAN MSW, LIACSW
Social Worker (Clinical)
9311 BRIDGEPORT WAY SW
LAKEWOOD, WA 98499
Pierce County (253) 617-3559
LAKEWOOD CHILD AND FAMILY COUNSELING LLC
Counselor (Mental Health)
9311 BRIDGEPORT WAY SW
LAKEWOOD, WA 98499
Pierce County (253) 617-3559

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Michelle Klekota-chisholm's NPI number?

The NPI number for Michelle Klekota-chisholm is 1740438779. It was assigned to this individual provider in the NPPES registry on September 3, 2008.

Where is Michelle Klekota-chisholm located?

Michelle Klekota-chisholm practices at 9311 Bridgeport Way SW, Lakewood, WA 98499. The listed phone number is (253) 617-3559.

What is Michelle Klekota-chisholm's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Mental Health, with taxonomy code 101YM0800X.

Is Michelle Klekota-chisholm enrolled in Medicare?

No. Michelle Klekota-chisholm has opted out of Medicare through January 1, 2028. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out.

When was this NPI record last updated?

The NPPES record for Michelle Klekota-chisholm was last updated on May 16, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.