NPIMap

Organization Active NPI

Brooke Psychologists, LLC

  • Clinical Psychologist
  • Portland, OR
National Provider Identifier
1093980070
Registry record updated Aug 18, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PY00003704 Issued in WA
Legal business name
BROOKE PSYCHOLOGISTS, LLC
Practice address
516 SE Morrison St
Ste 310
Portland, OR 97214-2327
Phone
(503) 235-8696
Fax
(503) 232-0791
NPI assigned
Apr 29, 2008
Last updated
Aug 18, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 18, 2008

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

Authorized official

Name
Dr. Michael Brooke, PSY.D.NPI 1275645061
Title
Clinical Psychologist
Phone
(503) 481-0020

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X PY00003079 WA
Clinical Psychologist 103TC0700X 1623 OR
Clinical Psychologist 103TC0700X 1830 OR
Clinical Psychologist 103TC0700X PY00003704 WA Primary

Addresses

Primary practice location

516 SE Morrison St
Ste 310
Portland, OR 97214-2327

Mailing address

516 SE Morrison St
Ste 310
Portland, OR 97214-2327
Phone (503) 235-8696

National Provider Directory

National Provider Directory

Locations

516 SE Morrison St
Ste 310
Portland, OR 97214
Phone (503) 235-8696

Practitioners & affiliated clinicians

Practitioners 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1209427200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1219017600000",
    "number": "1093980070",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "516 SE MORRISON ST",
            "address_2": "STE 310",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972142327",
            "telephone_number": "503-235-8696",
            "fax_number": "503-232-0791"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "516 SE MORRISON ST",
            "address_2": "STE 310",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972142327",
            "telephone_number": "503-235-8696",
            "fax_number": "503-232-0791"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BROOKE PSYCHOLOGISTS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-29",
        "last_updated": "2008-08-18",
        "status": "A",
        "authorized_official_last_name": "BROOKE",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "CLINICAL PSYCHOLOGIST",
        "authorized_official_telephone_number": "503-481-0020",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PSY.D."
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "WA",
            "license": "PY00003079",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "OR",
            "license": "1623",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "OR",
            "license": "1830",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "WA",
            "license": "PY00003704",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 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.