Andre Bryant

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

Practice address

721 Fawcett Ave Ste 101
Tacoma, WA 98402-5502

Phone

(253) 207-4301

NPI assigned

Oct 4, 2022

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

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.

• Metropolitan Development Council

  • Substance Abuse Rehabilitation Facility
  • Tacoma, WA
  • NPI 1235255092
  NPD (past)

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

{
    "created_epoch": "1664841600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664841600000",
    "number": "1043935927",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8428 6TH AVE APT 5",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984651058",
            "telephone_number": "253-207-4301"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "721 FAWCETT AVE STE 101",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984025502",
            "telephone_number": "253-207-4301"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRYANT",
        "first_name": "ANDRE",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-10-04",
        "last_updated": "2022-10-04",
        "certification_date": "2022-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "abryant@mdc-hope.org",
            "affiliation": "N",
            "endpointDescription": "email address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "721 Fawcett Ave Ste 101",
            "city": "Tacoma",
            "state": "WA",
            "country_code": "US",
            "postal_code": "984025502",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Kyle James Bruso
• Amber Lynne Brusso, LMP
• Brwe LLC
• Angela Roman Bryan, M.D.
• Kaitlyn Alexandra Bryan, CCC-SLP
• Anjanette Monique Bryant
• Ashley Starr Bryant, RN
• Brianna Bryant, LICSW, LMSW
• Carmen Melanie Bryant, M.A., ED. D., LMHC
• Heather Lucette Bryant, PT

• Professional Counselor in Tacoma, WA
• Providers in Tacoma, WA by specialty
• Professional Counselor in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2022; 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.