Individual provider Active NPI

Brenda Jo Wilkes, BRENDA WILKES, LCSW

  • Clinical Social Worker
  • Hillsboro, OR
National Provider Identifier
1043461205
Registry record updated Oct 7, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
L4302 Issued in OR
Practice address
21210 NW Mauzey Rd.
Hillsboro, OR 97124
Phone
(503) 439-9531
Fax
(503) 531-3841
NPI assigned
Oct 7, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 7, 2008

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X L4302 OR Primary

Addresses

Primary practice location

21210 NW Mauzey Rd.
Hillsboro, OR 97124

Mailing address

21210 NW Mauzey Rd
Hillsboro, OR 97124-9327
Phone (503) 439-9531

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
L4302ORMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Western Psychological and Counseling Services PC Past Accepting new patients
Western Psychological and Counseling Services LLC Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1223337600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1223337600000",
    "number": "1043461205",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21210 NW MAUZEY RD",
            "city": "HILLSBORO",
            "state": "OR",
            "postal_code": "971249327",
            "telephone_number": "503-439-9531",
            "fax_number": "503-531-3841"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21210 NW MAUZEY RD.",
            "city": "HILLSBORO",
            "state": "OR",
            "postal_code": "97124",
            "telephone_number": "503-439-9531",
            "fax_number": "503-531-3841"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILKES",
        "first_name": "BRENDA",
        "middle_name": "JO",
        "credential": "BRENDA WILKES, LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-10-07",
        "last_updated": "2008-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OR",
            "license": "L4302",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hillsboro, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.