Individual provider Active NPI

Brett Johnson, LMFT

  • Marriage & Family Therapist
  • Tigard, OR
National Provider Identifier
1568964252
Registry record updated Jul 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
T1602 Issued in OR
Practice address
11650 SW 67TH Ave
Tigard, OR 97223-8589
Phone
(503) 208-4563
NPI assigned
Mar 8, 2018
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 2, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X T1602 OR Primary

Addresses

Primary practice location

11650 SW 67TH Ave
Tigard, OR 97223-8589

Mailing address

15875 Boones Ferry Rd Unit 1254
Lake Grove, OR 97035-0812
Phone (503) 208-4635

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
T1602ORMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Ally Counseling, LLC CurrentSince Feb 7, 2021 Accepting new patients

Locations

15875 Boones Ferry Rd
Unit 1254
Lake Grove, OR 97035

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": "1520467200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1751414400000",
    "number": "1568964252",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15875 BOONES FERRY RD UNIT 1254",
            "city": "LAKE GROVE",
            "state": "OR",
            "postal_code": "970350812",
            "telephone_number": "503-208-4635"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11650 SW 67TH AVE",
            "city": "TIGARD",
            "state": "OR",
            "postal_code": "972238589",
            "telephone_number": "503-208-4563"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "BRETT",
        "credential": "LMFT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-03-08",
        "last_updated": "2025-07-02",
        "certification_date": "2025-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "OR",
            "license": "T1602",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tigard, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2025; 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.