Micah Larsen Brannon, SUDPT

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

CO61152752 Issued in WA

Practice address

819 N Miller St Ste 1B
Wenatchee, WA 98801-6604

Phone

(509) 664-4592

Fax

(509) 664-3594

NPI assigned

Mar 18, 2022

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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

• Columbia Valley Community Health

  • Federally Qualified Health Center (FQHC)
  • Wenatchee, WA
  • NPI 1346266152

  Addiction (Substance Use Disorder)

  NPD (past)

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

{
    "created_epoch": "1647561600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1647561600000",
    "number": "1396494332",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 ORONDO AVE STE 1",
            "city": "WENATCHEE",
            "state": "WA",
            "postal_code": "988012800",
            "telephone_number": "509-662-6000",
            "fax_number": "509-664-4590"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "819 N MILLER ST STE 1B",
            "city": "WENATCHEE",
            "state": "WA",
            "postal_code": "988016604",
            "telephone_number": "509-664-4592",
            "fax_number": "509-664-3594"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRANNON",
        "first_name": "MICAH",
        "middle_name": "LARSEN",
        "credential": "SUDPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-03-18",
        "last_updated": "2022-03-18",
        "certification_date": "2022-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "WA",
            "license": "CO61152752",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ashley Dawn Boyer, R.N., L.M.P.
• Jamie Boykin, CNM
• Katherine Bradshaw, RDH
• Scott Montgomery Branch, D.O.
• Emily Rae Brandeberry, DPT
• Amanda J Brantner, RN
• Laurie Braunstein, L.M.
• Arturo Bravo, DDS
• Lisamarie Brazeau, DDS, MS, PS
• Debbie A. Breckenridge, LMP

• Addiction (Substance Use Disorder) Counselor in Wenatchee, WA
• Providers in Wenatchee, WA by specialty
• Addiction (Substance Use Disorder) Counselor in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2022; 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.