Individual provider Active NPI

Brianna Paul Cook

  • Addiction (Substance Use Disorder) Counselor
  • Redmond, OR
National Provider Identifier
1356128359
Registry record updated Jan 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
T-23-2791 Issued in OR
Practice address
676 NE Maple Ave
Redmond, OR 97756-8527
Phone
(541) 504-9577
NPI assigned
Sep 12, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 2, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Peer Specialist 175T00000X
Addiction (Substance Use Disorder) Counselor 101YA0400X T-23-2791 OR Primary

Addresses

Primary practice location

676 NE Maple Ave
Redmond, OR 97756-8527

Mailing address

PO Box 1710
Redmond, OR 97756-0516
Phone (541) 516-4099

Other identifiers 1

IdentifierTypeStateIssuer
7605417OtherORODL

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
T-23-2791ORMDAddiction (Substance Use Disorder) Counselor

NPI Registry JSON

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

{
    "created_epoch": "1694476800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1735776000000",
    "number": "1356128359",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1710",
            "city": "REDMOND",
            "state": "OR",
            "postal_code": "977560516",
            "telephone_number": "541-516-4099"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "676 NE MAPLE AVE",
            "city": "REDMOND",
            "state": "OR",
            "postal_code": "977568527",
            "telephone_number": "541-504-9577"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COOK",
        "first_name": "BRIANNA",
        "middle_name": "PAUL",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-09-12",
        "last_updated": "2025-01-02",
        "certification_date": "2025-01-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "175T00000X",
            "taxonomy_group": "",
            "desc": "Peer Specialist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "OR",
            "license": "T-23-2791",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ODL",
            "identifier": "7605417",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Redmond, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 2, 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.