Brian L Imber, PSYCHOLOGIST, LMHC

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PSY32640 Issued in CA

Practice address

11522 NE 21St St Ste 100
Bellevue, WA 98004-3025

Phone

(206) 456-5450

NPI assigned

Aug 5, 2017

Sex

Male

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1501891200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631404800000",
    "number": "1487179925",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6688 WATERTON CIR",
            "city": "MUKILTEO",
            "state": "WA",
            "postal_code": "982754805",
            "telephone_number": "425-563-3099"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11522 NE 21ST ST STE 100",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980043025",
            "telephone_number": "206-456-5450"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "543 Encinitas Blvd Ste 114",
            "address_purpose": "LOCATION",
            "city": "Encinitas",
            "state": "CA",
            "postal_code": "920243744",
            "country_code": "US",
            "telephone_number": "425-563-3099",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6688 Waterton Cir",
            "address_purpose": "LOCATION",
            "city": "Mukilteo",
            "state": "WA",
            "postal_code": "982754805",
            "country_code": "US",
            "telephone_number": "425-563-3099",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "IMBER",
        "first_name": "BRIAN",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "PSYCHOLOGIST, LMHC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-08-05",
        "last_updated": "2021-09-12",
        "certification_date": "2021-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WA",
            "license": "LH61027314",
            "primary": false
        },
        {
            "code": "246ZE0500X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Other, EEG",
            "state": "WA",
            "license": "LH61027314",
            "primary": false
        },
        {
            "code": "246ZE0500X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Other, EEG",
            "state": "CA",
            "license": "PSY32640",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY32640",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mellissa Ann Ilgen, D.D.S.
• Victoria Ili
• Aaron A Ilk, DC
• Edward Im, DDS
• Jelissa Iman-Olea
• Kathryn Marie Imberg, D.O.
• Maria Lee Imbesi, PA-C
• Immune Disease Treatment Services PLLC
• Annie Vang Imoto
• Julia K Imoto, LMP

• Clinical Psychologist in Bellevue, WA
• Providers in Bellevue, WA by specialty
• Clinical Psychologist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2021; 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.