Individual provider Active NPI

Michell Brockman

  • Mental Health Counselor
  • Vancouver, WA
National Provider Identifier
1063948685
Registry record updated Jul 21, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Practice address
13023 NE Highway 99 Ste 7
Vancouver, WA 98686-2699
Phone
(360) 329-2887
NPI assigned
May 2, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 21, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X WA Primary

Addresses

Primary practice location

13023 NE Highway 99 Ste 7
Vancouver, WA 98686-2699

Mailing address

13023 NE Highway 99 Ste 7
Vancouver, WA 98686-2699
Phone (360) 329-2887

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Jan 1, 2024 through Jan 1, 2028

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1493683200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1784592000000",
    "number": "1063948685",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13023 NE HIGHWAY 99 STE 7",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986862699",
            "telephone_number": "360-329-2887"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13023 NE HIGHWAY 99 STE 7",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986862699",
            "telephone_number": "360-329-2887"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROCKMAN",
        "first_name": "MICHELL",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-05-02",
        "last_updated": "2026-07-21",
        "certification_date": "2026-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vancouver, WA

Sources for this page

Verify at the official NPI Registry.