NPIMap

Organization Active NPI

Kelle Debruin Counseling, LLC

  • Mental Health Counselor
  • Tigard, OR
National Provider Identifier
1376290809
Registry record updated Sep 29, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Legal business name
KELLE DEBRUIN COUNSELING, LLC
Practice address
7320 SW Hunziker Rd Ste 201
Tigard, OR 97223-2301
Phone
(503) 778-0787
Fax
(503) 296-2938
NPI assigned
Mar 4, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 29, 2023

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

Authorized official

Name
Kelle Lea Nelson-Debruin, LMFTNPI 1982255881
Title
Therapist/Owner
Phone
(503) 778-0787

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101YM0800X Primary

Addresses

Primary practice location

7320 SW Hunziker Rd Ste 201
Tigard, OR 97223-2301

Mailing address

1300 John Adams St # 111
Oregon City, OR 97045-1695
Phone (503) 778-0787

Other identifiers 1

IdentifierTypeStateIssuer
500774617MedicaidOR

National Provider Directory

National Provider Directory

Locations

1300 John Adams St
#111
Oregon City, OR 97045
Phone (503) 778-0787

7320 SW Hunziker Rd
Ste 201
Tigard, OR 97223
Phone (503) 778-0787

Practitioners & affiliated clinicians

Practitioners 20

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 20

NPI Registry JSON

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

{
    "created_epoch": "1646352000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1695945600000",
    "number": "1376290809",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1300 JOHN ADAMS ST # 111",
            "city": "OREGON CITY",
            "state": "OR",
            "postal_code": "970451695",
            "telephone_number": "503-778-0787",
            "fax_number": "503-296-2938"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7320 SW HUNZIKER RD STE 201",
            "city": "TIGARD",
            "state": "OR",
            "postal_code": "972232301",
            "telephone_number": "503-778-0787",
            "fax_number": "503-296-2938"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KELLE DEBRUIN COUNSELING, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-03-04",
        "last_updated": "2023-09-29",
        "certification_date": "2023-09-29",
        "status": "A",
        "authorized_official_last_name": "NELSON-DEBRUIN",
        "authorized_official_first_name": "KELLE",
        "authorized_official_middle_name": "LEA",
        "authorized_official_title_or_position": "THERAPIST/OWNER",
        "authorized_official_telephone_number": "503-778-0787",
        "authorized_official_credential": "LMFT"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500774617",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tigard, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2023; 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.