Active NPI
Julie Brenneise, MA
- Mental Health Counselor
- Normandy Park, WA
National Provider Identifier
1447823018
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- MC61029936
- Practice address
- 19655 1St Ave S Ste 206
Normandy Park, WA 98148-2172 - Phone
- (517) 974-9723
- NPI assigned
- Jul 21, 2021
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | MC61029936 | WA | Primary |
Addresses
Primary practice location
19655 1St Ave S Ste 206
Normandy Park, WA 98148-2172
Mailing address
19655 1St Ave S Ste 206
Normandy Park, WA 98148-2172
Phone (517) 974-9723
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Previously, effective Sep 12, 2024 through Sep 12, 2026
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MC61029936 | WA | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1626825600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1626825600000",
"number": "1447823018",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "19655 1ST AVE S STE 206",
"city": "NORMANDY PARK",
"state": "WA",
"postal_code": "981482172",
"telephone_number": "517-974-9723"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "19655 1ST AVE S STE 206",
"city": "NORMANDY PARK",
"state": "WA",
"postal_code": "981482172",
"telephone_number": "517-974-9723"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRENNEISE",
"first_name": "JULIE",
"credential": "MA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2021-07-21",
"last_updated": "2021-07-21",
"certification_date": "2021-07-21",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "WA",
"license": "MC61029936",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Normandy Park, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.