Breaking Chains Therapy LLC

Primary specialty

PsychologistTaxonomy code 103T00000X

License

1880 Issued in OR

Legal business name

BREAKING CHAINS THERAPY LLC

Practice address

710C E Foothills Dr.
Suite 103
Newberg, OR 97132-6125

Phone

(503) 964-7642

NPI assigned

Aug 31, 2016

Last updated

Aug 31, 2016By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Corrina Brandstetter, PSYD

Title

Owner

Phone

(503) 964-7642

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Corinna Lee Brandstetter, PSY.D.

  • Clinical Psychologist
  • Newberg, OR
  • NPI 1376735027
  NPD (past)

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

{
    "created_epoch": "1472601600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1472601600000",
    "number": "1083160931",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "710C E FOOTHILLS DR.",
            "address_2": "SUITE 103",
            "city": "NEWBERG",
            "state": "OR",
            "postal_code": "971326125",
            "telephone_number": "503-964-7642"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "710C E FOOTHILLS DR.",
            "address_2": "SUITE 103",
            "city": "NEWBERG",
            "state": "OR",
            "postal_code": "971326125",
            "telephone_number": "503-964-7642"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BREAKING CHAINS THERAPY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-08-31",
        "last_updated": "2016-08-31",
        "status": "A",
        "authorized_official_last_name": "BRANDSTETTER",
        "authorized_official_first_name": "CORRINA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "503-964-7642",
        "authorized_official_credential": "PSYD"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "OR",
            "license": "1880",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PROVIDER NPI",
            "identifier": "1376735027",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lecia Sue-Anne Boyd, PHMNP-BC
• Hilary Vanessa Bramley, L.M.T.
• Corinna Lee Brandstetter, PSY.D.
• Michael Johnson Brask, PA-C
• Bread of Life Care Inc
• Christopher J Brecke, D.D.S
• John Richard Breen, LCDC
• Patrick Bridge, P.T.
• Shannon S. Brigman, M.D.
• Kimberly Alyse Britsch, DO

• Psychologist in Newberg, OR
• Providers in Newberg, OR by specialty
• Psychologist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2016; 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.