Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Kane Carlock, LMHCA

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1558062430

Kane Carlock, LMHCA is a Clinical Psychologist in Renton, Washington. Qualified in 2024, 2 years ago. Practices with Healthsource of Ohio Inc, a 56-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Washington.

Years since qualifying
2
Licensed in
WA
In the registry since
2023
Specialties on file
2
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Practice location Address checks out

200 S 2nd St
Renton, WA 98057-2011
Phone: (425) 226-5536
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 2902 Ne 12th St Ste 102, Renton, WA 98056-3297 — (425) 882-6000

Specialties & licences

Counselor (primary) Taxonomy 101Y00000X · Licence MC61422758 (WA)
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X

Record details

NPI number1558062430
Entity typeIndividual (Type 1)
GenderMale
Credentials LMHCA
Sole proprietorNo
NPI enumeratedMarch 16, 2023
Last updated in NPPESJuly 27, 2023
Certification dateJuly 27, 2023
Mailing address955 Powell Ave Sw, Renton, WA 98057-2908

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyCLINICAL PSYCHOLOGIST
Medical schoolOTHER
Graduated 2024 (2 years in practice)
Group practice Healthsource Of Ohio Inc — 56 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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