Individual provider Active NPI

Brandt Vansoolen

  • Mental Health Counselor
  • McMinnville, OR
National Provider Identifier
1417512831
Registry record updated May 1, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Practice address
627 NE Evans St
McMinnville, OR 97128-3923
Phone
(503) 434-7523
Fax
(503) 434-9846
NPI assigned
May 1, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 1, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X Primary

Addresses

Primary practice location

627 NE Evans St
McMinnville, OR 97128-3923

Mailing address

3438 Gulfport St NE
Salem, OR 97305-1514
Phone (580) 458-1713

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240313004064 OR Practitioner - Mental Health Counselor 3274979141 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Yamhill CountyGroup PAC ID 3274421169, 19 clinicians

Practice addresses (Care Compare)

627 N Evans St
McMinnville, OR 97128-3923
Phone (503) 434-7525

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Yamhill County CurrentSince Jan 15, 2024 Accepting new patients
Yamhill County CurrentSince Jan 15, 2024 Accepting new patients

Locations

627 NE Evans St
McMinnville, OR 97128
Phone (503) 434-7527

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1556668800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1556668800000",
    "number": "1417512831",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3438 GULFPORT ST NE",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973051514",
            "telephone_number": "580-458-1713"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "627 NE EVANS ST",
            "city": "MCMINNVILLE",
            "state": "OR",
            "postal_code": "971283923",
            "telephone_number": "503-434-7523",
            "fax_number": "503-434-9846"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANSOOLEN",
        "first_name": "BRANDT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-05-01",
        "last_updated": "2019-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in McMinnville, OR

Sources for this page

Verify at the official NPI Registry.