Individual provider Active NPI

Brianne Jalayne Deyoung

  • Professional Counselor
  • Salem, OR
National Provider Identifier
1114373834
Registry record updated Jul 5, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
C6392 Issued in OR
Practice address
3085 River Rd N
Salem, OR 97303-6512
Phone
(541) 321-2278
Fax
(541) 246-8826
NPI assigned
May 12, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 5, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X
Mental Health Counselor 101YM0800X R5444 OR
Professional Counselor 101YP2500X C6392 OR Primary

Addresses

Primary practice location

3085 River Rd N
Salem, OR 97303-6512

Mailing address

6672 Veranda CT N
Keizer, OR 97303-4226
Phone (503) 867-0350

Other practice location 1

222 SE 8th Ave Ste 212
Hillsboro, OR 97123-4218
Phone (503) 352-7333

Other practice location 2

112 E Burnett St
Stayton, OR 97383-1735
Phone (503) 509-5275

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240201000900 OR Practitioner - Mental Health Counselor 3476906801 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
R5444ORMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Arise Counseling Service, LLC. Dba Northlight Counseling Professional CurrentSince Jan 1, 2024 Accepting new patients
Pacific University Past Accepting new patients

Locations

2225 Pacific Blvd SE
Ste 101
Albany, OR 97321
Phone (541) 321-2278

1075 Washington St
Eugene, OR 97401
Phone (541) 321-2278

2440 Willamette St
Ste 201
Eugene, OR 97405
Phone (541) 234-3090

3085 River Rd N
Salem, OR 97303
Phone (541) 321-2278

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": "1463011200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688515200000",
    "number": "1114373834",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6672 VERANDA CT N",
            "city": "KEIZER",
            "state": "OR",
            "postal_code": "973034226",
            "telephone_number": "503-867-0350"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3085 RIVER RD N",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973036512",
            "telephone_number": "541-321-2278",
            "fax_number": "541-246-8826"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "222 SE 8th Ave Ste 212",
            "address_purpose": "LOCATION",
            "city": "Hillsboro",
            "state": "OR",
            "postal_code": "971234218",
            "country_code": "US",
            "telephone_number": "503-352-7333",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "112 E Burnett St",
            "address_purpose": "LOCATION",
            "city": "Stayton",
            "state": "OR",
            "postal_code": "973831735",
            "country_code": "US",
            "telephone_number": "503-509-5275",
            "fax_number": "503-767-3456",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DEYOUNG",
        "first_name": "BRIANNE",
        "middle_name": "JALAYNE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-05-12",
        "last_updated": "2023-07-05",
        "certification_date": "2023-07-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "OR",
            "license": "R5444",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "OR",
            "license": "C6392",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salem, OR

Sources for this page

Verify at the official NPI Registry.