Individual provider Active NPI

Brianna Puetz

  • Mental Health Counselor
  • Columbus, OH
National Provider Identifier
1558741082
Registry record updated Jul 19, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
C1600444 Issued in OH
Practice address
929 Harrison Ave Ste 300
Columbus, OH 43215-1346
Phone
(614) 259-8052
NPI assigned
May 29, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 19, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X C1600444 OH
Mental Health Counselor 101YM0800X C1600444 OH Primary

Addresses

Primary practice location

929 Harrison Ave Ste 300
Columbus, OH 43215-1346

Mailing address

401 NE 19TH Ave Ste 200
Portland, OR 97232-4800
Phone (503) 298-4661

Other practice location 1

401 NE 19th Ave Ste 200
Portland, OR 97232-4800
Phone (503) 298-4661

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

LicenseStateTypeSpecialty
C1600444OHMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Endeavor Counseling and Consultation LLC Mental Health Current Accepting new patients

Locations

401 NE 19th Ave
Ste 200
Portland, OR 97232
Phone (206) 554-1900

Organizations & group practices 1

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": "1432857600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658188800000",
    "number": "1558741082",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 NE 19TH AVE STE 200",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972324800",
            "telephone_number": "503-298-4661"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "929 HARRISON AVE STE 300",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432151346",
            "telephone_number": "614-259-8052"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "401 NE 19th Ave Ste 200",
            "address_purpose": "LOCATION",
            "city": "Portland",
            "state": "OR",
            "postal_code": "972324800",
            "country_code": "US",
            "telephone_number": "503-298-4661",
            "fax_number": "971-288-0587",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PUETZ",
        "first_name": "BRIANNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-05-29",
        "last_updated": "2022-07-19",
        "certification_date": "2022-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "OH",
            "license": "C1600444",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "OH",
            "license": "C1600444",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbus, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2022; 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.