Willie Charles Brantley, RECOVERY COACH

Primary specialty

Peer SpecialistTaxonomy code 175T00000X

License

1011-0319 Issued in TX

Practice address

3501 Brewster St
Houston, TX 77026-4446

Phone

(512) 293-2526

NPI assigned

Jun 11, 2019

Last updated

Jun 11, 2019By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1560211200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560211200000",
    "number": "1295394419",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10106 FONVILLE DR",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770753304",
            "telephone_number": "832-858-3024"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3501 BREWSTER ST",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770264446",
            "telephone_number": "512-293-2526"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3124 Prospect St",
            "address_purpose": "LOCATION",
            "city": "Houston",
            "state": "TX",
            "postal_code": "770046209",
            "country_code": "US",
            "telephone_number": "512-293-2526",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BRANTLEY",
        "first_name": "WILLIE",
        "middle_name": "CHARLES",
        "credential": "RECOVERY COACH",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-06-11",
        "last_updated": "2019-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "175T00000X",
            "taxonomy_group": "",
            "desc": "Peer Specialist",
            "state": "TX",
            "license": "1011-0319",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "Peer/Support",
            "affiliation": "N",
            "address_1": "3501 Brewster St",
            "city": "Houston",
            "state": "TX",
            "country_code": "US",
            "postal_code": "770264446",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Andre Brantley, APRN-C
• Chassity Brantley, LMSW
• Condya Rosheryl Brantley
• Rhonda Michelle Brantley, NURSE PRACTITIONER
• Sidney Brantley
• Si'Mone Braquet, OT
• Seeta Brar
• Barbett Brashear, LBSW
• Kiel Steven Brasher, CRNA
• Maya Iyengar Brasher, M.D.

• Peer Specialist in Houston, TX
• Providers in Houston, TX by specialty
• Peer Specialist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2019; 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.