Active NPI
Brian Or'Deal Carpenter, CDPT
- Addiction (Substance Use Disorder) Counselor
- Seattle, WA
National Provider Identifier
1497021729
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction (Substance Use Disorder) Counselor
- License
- CO 60108458
- Practice address
- 1116 Summit Ave
Seattle, WA 98101-2831 - Phone
- (206) 323-0930
- NPI assigned
- Mar 30, 2012
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | CO 60108458 | WA | Primary |
Addresses
Primary practice location
1116 Summit Ave
Seattle, WA 98101-2831
Mailing address
1116 Summit Ave
Seattle, WA 98101-2831
Phone (206) 323-0930
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| CO 60108458 | Other | WA | CHEMICAL DEPENDENCY PROFESSIONAL TRAINEE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| CO 60108458 | WA | MD | Addiction (Substance Use Disorder) Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1333065600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1333065600000",
"number": "1497021729",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1116 SUMMIT AVE",
"city": "SEATTLE",
"state": "WA",
"postal_code": "981012831",
"telephone_number": "206-323-0930"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1116 SUMMIT AVE",
"city": "SEATTLE",
"state": "WA",
"postal_code": "981012831",
"telephone_number": "206-323-0930"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CARPENTER",
"first_name": "BRIAN",
"middle_name": "OR'DEAL",
"credential": "CDPT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2012-03-30",
"last_updated": "2012-03-30",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "WA",
"license": "CO 60108458",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CHEMICAL DEPENDENCY PROFESSIONAL TRAINEE",
"identifier": "CO 60108458",
"state": "WA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Seattle, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.