Angela Ann Brumfield, SUDP

Key facts

NPI: 1457065054
Entity type: Individual (NPI type 1)
Primary specialty: Addiction (Substance Use Disorder) Counselor 101YA0400X
License: CP00000553 (WA)
Practice address: 511 W Heron St
Aberdeen, WA 98520-6022
Phone: (564) 544-1943
Fax: (564) 544-1928
NPI assigned: Jan 9, 2023
Sex: Female
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

State licenses

License	State	Type	Specialty
CP00000553	WA	MD	Addiction (Substance Use Disorder) Counselor

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Addiction (Substance Use Disorder) Counselor	101YA0400X	CP00000553	WA	Yes

Addresses

Primary practice location

511 W Heron St
Aberdeen, WA 98520-6022

Mailing address

511 W Heron St
Aberdeen, WA 98520-6022
Phone (564) 544-1943

Other names

Angela Ann Brumfield-Leaks Former name

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Jan 9, 2023.

{
    "created_epoch": "1673222400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1673222400000",
    "number": "1457065054",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "511 W HERON ST",
            "city": "ABERDEEN",
            "state": "WA",
            "postal_code": "985206022",
            "telephone_number": "564-544-1943",
            "fax_number": "564-544-1928"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "511 W HERON ST",
            "city": "ABERDEEN",
            "state": "WA",
            "postal_code": "985206022",
            "telephone_number": "564-544-1943",
            "fax_number": "564-544-1928"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRUMFIELD",
        "first_name": "ANGELA",
        "middle_name": "ANN",
        "name_prefix": "Ms.",
        "credential": "SUDP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-01-09",
        "last_updated": "2023-01-09",
        "certification_date": "2023-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "WA",
            "license": "CP00000553",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANGELA",
            "last_name": "BRUMFIELD-LEAKS",
            "middle_name": "ANN",
            "credential": "SUDP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Aberdeen, WA

All providers in Aberdeen, WA · Addiction (Substance Use Disorder) Counselor in Washington

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 9, 2023. 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.

Verify at the official NPI Registry.