Elijah J Brunson
Individual provider Active NPI Mental Health Counselor · Brookings, OR
NPI 1386440964 · NPPES record last updated Feb 24, 2025
Key facts
- NPI
- 1386440964
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Mental Health Counselor 101YM0800X
- Practice address
- 615 5TH St # 300
Brookings, OR 97415-9199 - Phone
- (877) 408-8941
- NPI assigned
- Feb 24, 2025
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | |||
| Case Manager/Care Coordinator | 171M00000X | |||
| Mental Health Counselor | 101YM0800X | Yes |
Addresses
Primary practice location
615 5TH St # 300
Brookings, OR 97415-9199
Mailing address
PO Box 1121
Roseburg, OR 97470-0254
Phone (541) 672-2691
Other providers in Brookings, OR
- Brookings Dental Group, LLC
- Brookings Harbor Family Practice Clinic
- Brookings Harbor Medical Center P C
- Herman Brown Jr.
- James Edward Brown
- Linda S. Brunson
- Donna Buick
- Lori A Burkart
- Denise Burnham
- Hester Charlotte Burton
All providers in Brookings, OR · Mental Health Counselor in Oregon
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 24, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.