Individual provider Active NPI

Brianne Kiso

  • Clinical Social Worker
  • Bend, OR
National Provider Identifier
1396286746
Registry record updated Dec 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
L15951 Issued in OR
Practice address
516 SW 13TH St Ste 201
Bend, OR 97702-3442
Phone
(541) 640-3031
Fax
(541) 550-1495
NPI assigned
Mar 18, 2017
Last updated
Dec 30, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 30, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X L15951 OR Primary

Addresses

Primary practice location

516 SW 13TH St Ste 201
Bend, OR 97702-3442

Mailing address

516 SW 13TH St Ste 201
Bend, OR 97702-3442
Phone (541) 640-3031

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
L15951ORMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Peak Wellness Services Mental Health CurrentSince Jun 23, 2024 Accepting new patients
Yasuragi Therapy Services, LLC Clinical Current Accepting new patients

Locations

516 SW 13th St
Ste 201
Bend, OR 97702
Phone (541) 640-3031

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1489795200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1735516800000",
    "number": "1396286746",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "516 SW 13TH ST STE 201",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977023442",
            "telephone_number": "541-640-3031",
            "fax_number": "541-550-1495"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "516 SW 13TH ST STE 201",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977023442",
            "telephone_number": "541-640-3031",
            "fax_number": "541-550-1495"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KISO",
        "first_name": "BRIANNE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-03-18",
        "last_updated": "2024-12-30",
        "certification_date": "2024-12-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OR",
            "license": "L15951",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bend, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 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.

Verify at the official NPI Registry.