Brandi Sue Defazio, MHA, MA, LMFT

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

LF60595316 Issued in WA

Practice address

310 3Rd Ave NE Ste 118
Issaquah, WA 98027-3348

Phone

(425) 894-9676

NPI assigned

Jul 26, 2015

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Ms. Brandi Sue Spunt Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

State licenses

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

{
    "created_epoch": "1437868800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1440720000000",
    "number": "1366827875",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12036 198TH AVE SE",
            "city": "ISSAQUAH",
            "state": "WA",
            "postal_code": "980278522",
            "telephone_number": "425-226-0609"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "310 3RD AVE NE STE 118",
            "city": "ISSAQUAH",
            "state": "WA",
            "postal_code": "980273348",
            "telephone_number": "425-894-9676"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEFAZIO",
        "first_name": "BRANDI",
        "middle_name": "SUE",
        "name_prefix": "Ms.",
        "credential": "MHA, MA, LMFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-07-26",
        "last_updated": "2015-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "WA",
            "license": "LF60595316",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BRANDI",
            "last_name": "SPUNT",
            "middle_name": "SUE",
            "prefix": "MS.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Jennifer Anne Martinell De Alba, MA, LMHC
• Candice De Sauvage
• Dean Riskedahl, OD, PS
• Suzette Debutts, MS OTR/L
• April A. Decker
• Stacy Danae Deffner, M.A., CCC-SLP
• Christian F Deisler
• Nima Dejbod, DMD
• Reinier Dejong Vancoevorden, M.D.
• Simone Dekker, MD, PHD

• Marriage & Family Therapist in Issaquah, WA
• Providers in Issaquah, WA by specialty
• Marriage & Family Therapist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 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.

Verify at the official NPI Registry.