Active NPI
Brooke Anderson, MSW, QMHP
- Clinical Social Worker
- Portland, OR
National Provider Identifier
1376725523
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 7480
- Practice address
- 4212 SE Division St
Portland, OR 97206-1628 - Phone
- (503) 238-0705
- NPI assigned
- Nov 29, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | |||
| Mental Health Counselor | 101YM0800X | |||
| Adult Companion | 372600000X | |||
| Clinical Social Worker | 1041C0700X | 7480 | OR | Primary |
Addresses
Primary practice location
4212 SE Division St
Portland, OR 97206-1628
Mailing address
PO Box 8459
Portland, OR 97207
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
| License | State | Type | Specialty |
|---|---|---|---|
| 7480 | OR | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1196294400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1732665600000",
"number": "1376725523",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 8459",
"city": "PORTLAND",
"state": "OR",
"postal_code": "97207"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4212 SE DIVISION ST",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972061628",
"telephone_number": "503-238-0705"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ANDERSON",
"first_name": "BROOKE",
"credential": "MSW, QMHP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-11-29",
"last_updated": "2024-11-27",
"certification_date": "2024-11-27",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": null,
"license": null,
"primary": false
},
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": null,
"license": null,
"primary": false
},
{
"code": "372600000X",
"taxonomy_group": "",
"desc": "Adult Companion",
"state": null,
"license": null,
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "OR",
"license": "7480",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Portland, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.