Jessica Brake, LPC, LLC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

Legal business name

JESSICA BRAKE, LPC, LLC

Practice address

2233 W Harvard Ave
Roseburg, OR 97471-2550

Phone

(541) 704-8745

NPI assigned

Sep 28, 2022

Organization subpart

No

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

Authorized official

Name

Jessica Brake, LPCNPI 1235412735

Title

Owner

Phone

(541) 670-2264

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jessica L Brake, MS

  • Professional Counselor
  • Roseburg, OR
  • NPI 1235412735
  NPD Authorized official

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

{
    "created_epoch": "1664323200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1664323200000",
    "number": "1578287090",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1756",
            "city": "ROSEBURG",
            "state": "OR",
            "postal_code": "974700420",
            "telephone_number": "541-670-2264"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2233 W HARVARD AVE",
            "city": "ROSEBURG",
            "state": "OR",
            "postal_code": "974712550",
            "telephone_number": "541-704-8745"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JESSICA BRAKE, LPC, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-09-28",
        "last_updated": "2022-09-28",
        "certification_date": "2022-09-28",
        "status": "A",
        "authorized_official_last_name": "BRAKE",
        "authorized_official_first_name": "JESSICA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "541-670-2264",
        "authorized_official_credential": "LPC"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500663462",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jennifer Ann Frost
• Jennifer M. Soyke, M.D., P.C.
• Krista Jensen
• Ryan Neal Jephson, BS
• Benjamin Edward Jeppe, D.C., AGPCNP
• Joel R Daven MD PC
• John Wrigley, M.D.,P.C.
• Kristoffer Scott Johns, CCC-SLP
• Alisha Johnson, LMT
• Heather Irene Johnson, MSW

• Professional Counselor in Roseburg, OR
• Providers in Roseburg, OR by specialty
• Professional Counselor in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 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.