Active NPI
Vicki Ann Bruno, LPC
- Marriage & Family Therapist
- Portland, OR
National Provider Identifier
1225248495
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- C1078
- Practice address
- 18088 SE Market St
Portland, OR 97233-5055 - Phone
- (971) 202-7866
- NPI assigned
- May 23, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | C1078 | OR | Primary |
Addresses
Primary practice location
18088 SE Market St
Portland, OR 97233-5055
Mailing address
18088 SE Market St
Portland, OR 97233-5055
Phone (971) 202-7866
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| C1078 | Other | OR | LICENSED PROFESSIONAL COU |
| 26994 | Other | NATIONAL CERTIFIED COUNSE |
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
| License | State | Type | Specialty |
|---|---|---|---|
| C1078 | OR | MD | Marriage & Family Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1179878400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1423612800000",
"number": "1225248495",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "18088 SE MARKET ST",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972335055",
"telephone_number": "971-202-7866"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "18088 SE MARKET ST",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972335055",
"telephone_number": "971-202-7866"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRUNO",
"first_name": "VICKI",
"middle_name": "ANN",
"name_prefix": "Ms.",
"credential": "LPC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-05-23",
"last_updated": "2015-02-11",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "OR",
"license": "C1078",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LICENSED PROFESSIONAL COU",
"identifier": "C1078",
"state": "OR"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NATIONAL CERTIFIED COUNSE",
"identifier": "26994",
"state": null
}
],
"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 Feb 11, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.