Michael Brouillette, ED.D, LMHC, CHT

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

LH61249379 Issued in WA

Practice address

4411 2ND St SW Ste 3
Puyallup, WA 98373-3726

Phone

(253) 444-4131

NPI assigned

Mar 10, 2022

Last updated

Mar 10, 2022By 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

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": "1646870400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646870400000",
    "number": "1356099279",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15315 95TH AVENUE CT E",
            "city": "PUYALLUP",
            "state": "WA",
            "postal_code": "983756712",
            "telephone_number": "253-444-4131"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4411 2ND ST SW STE 3",
            "city": "PUYALLUP",
            "state": "WA",
            "postal_code": "983733726",
            "telephone_number": "253-444-4131"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROUILLETTE",
        "first_name": "MICHAEL",
        "credential": "ED.D, LMHC, CHT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-03-10",
        "last_updated": "2022-03-10",
        "certification_date": "2022-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WA",
            "license": "LH61249379",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Mental Health Counselor in Puyallup, WA
• Providers in Puyallup, WA by specialty
• Mental Health Counselor in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2022; 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.