Individual provider Active NPI

Brian Nathan Sillanpaa

  • Mental Health Counselor
  • Tempe, AZ
National Provider Identifier
1164875241
Registry record updated Feb 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Practice address
4801 S Lakeshore Dr Ste 106
Tempe, AZ 85282-7156
Phone
(480) 525-0058
NPI assigned
Jul 13, 2016
Last updated
Feb 6, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 6, 2024

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 Primary

Addresses

Primary practice location

4801 S Lakeshore Dr Ste 106
Tempe, AZ 85282-7156

Mailing address

4801 S Lakeshore Dr Ste 106
Tempe, AZ 85282-7156
Phone (480) 525-0058

Other practice location 1

2131 E Broadway Rd Ste 1
Tempe, AZ 85282-1737
Phone (480) 525-0058

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 23, 2024 through Jan 23, 2028

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Breakthrough Behavioral North LLC Mental Health Current Accepting new patients
Breakthrough Behavioral Health CurrentSince Sep 1, 2022 Accepting new patients

Locations

2131 E Broadway Rd
Ste 1
Tempe, AZ 85282
Phone (480) 525-0058

4801 S Lakeshore Dr
Ste 106
Tempe, AZ 85282
Phone (480) 525-0058

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1468368000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707177600000",
    "number": "1164875241",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4801 S LAKESHORE DR STE 106",
            "city": "TEMPE",
            "state": "AZ",
            "postal_code": "852827156",
            "telephone_number": "480-525-0058"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4801 S LAKESHORE DR STE 106",
            "city": "TEMPE",
            "state": "AZ",
            "postal_code": "852827156",
            "telephone_number": "480-525-0058"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2131 E Broadway Rd Ste 1",
            "address_purpose": "LOCATION",
            "city": "Tempe",
            "state": "AZ",
            "postal_code": "852821737",
            "country_code": "US",
            "telephone_number": "480-525-0058",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SILLANPAA",
        "first_name": "BRIAN",
        "middle_name": "NATHAN",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-07-13",
        "last_updated": "2024-02-06",
        "certification_date": "2024-02-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tempe, AZ

Sources for this page

Verify at the official NPI Registry.