Kelly Mark, PSYD
NPI 1043561285ActiveIndividual· Psychologist· Bellevue, WA
Opted out of Medicare from January 2019 to January 2027. Psychologist (PSYD) in Bellevue, Washington, licensed in WA, with an NPI issued in September 2012.
Overview
| NPI | 1043561285 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Credential | PSYD |
| Sole proprietor | No |
| NPI issued | Sep 27, 2012 |
| Last updated in NPPES | May 24, 2018 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Psychologist Primary | 103T00000X | PY60781335 | WA |
| Counselor, Mental Health | 101YM0800X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Not in the public enrollment file of Oct 1, 2026 |
|---|---|
| Opt-out | Opted out Jan 5, 2019 – Jan 5, 2027 |
| Can order and refer | Yes |
During an opt-out period the provider sees Medicare patients only under private contracts, and Medicare does not pay claims for their services.
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