Individual provider Active NPI

Judy Ann Schmidt, MFT STUDENT INTERN

  • Student in an Organized Health Care Education/Training Program
  • Tigard, OR
National Provider Identifier
1114816352
Registry record updated Jul 1, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
License
T1928 Issued in OR
Practice address
7320 SW Hunziker Rd Ste 201
Tigard, OR 97223-2301
Phone
(503) 778-0787
Fax
(503) 296-2938
NPI assigned
Jul 1, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 1, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X T1928 OR Primary
Mental Health Counselor 101YM0800X T1928 OR

Addresses

Primary practice location

7320 SW Hunziker Rd Ste 201
Tigard, OR 97223-2301

Mailing address

4549 SE Brae St
Milwaukie, OR 97222-4783
Phone (503) 778-0787

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
T1928ORMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Kelle Debruin Counseling, LLC Mental Health CurrentSince Jul 9, 2025 Accepting new patients

Locations

7320 SW Hunziker Rd
Ste 201
Tigard, OR 97223
Phone (503) 778-0787

Organizations & group practices 1

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": "1751328000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1751328000000",
    "number": "1114816352",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4549 SE BRAE ST",
            "city": "MILWAUKIE",
            "state": "OR",
            "postal_code": "972224783",
            "telephone_number": "503-778-0787"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7320 SW HUNZIKER RD STE 201",
            "city": "TIGARD",
            "state": "OR",
            "postal_code": "972232301",
            "telephone_number": "503-778-0787",
            "fax_number": "503-296-2938"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHMIDT",
        "first_name": "JUDY",
        "middle_name": "ANN",
        "credential": "MFT STUDENT INTERN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-07-01",
        "last_updated": "2025-07-01",
        "certification_date": "2025-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "OR",
            "license": "T1928",
            "primary": true
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "OR",
            "license": "T1928",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tigard, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2025; 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.