Active NPI
Greta Cullen Brackman, CG60872398
- Case Manager/Care Coordinator
- Tacoma, WA
National Provider Identifier
1619462678
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Case Manager/Care Coordinator
- Practice address
- 1305 Tacoma Ave S
Tacoma, WA 98402-1903 - Phone
- (253) 320-5674
- NPI assigned
- Jun 22, 2018
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | CG60872398 | WA | |
| Case Manager/Care Coordinator | 171M00000X | Primary |
Addresses
Primary practice location
1305 Tacoma Ave S
Tacoma, WA 98402-1903
Mailing address
1305 Tacoma Ave S
Tacoma, WA 98402-1903
Phone (253) 320-5674
Other practice location 1
1305 Tacoma Ave S
Tacoma, WA 98402-1903
Phone (253) 320-5674
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 |
|---|---|---|---|
| CG60872398 | WA | MD | Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Comprehensive Mental Health Center of Tacoma-Pierce County | Single Specialty | Past | Accepting new patients |
| Comprehensive Mental Health | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Community/Behavioral Health Agency
- Tacoma, WA
- NPI 1720334170
-
dba Comprehensive Life Resources
- Community/Behavioral Health Agency
- Tacoma, WA
- NPI 1952597056
Single Specialty
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1529625600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1529625600000",
"number": "1619462678",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1305 TACOMA AVE S",
"city": "TACOMA",
"state": "WA",
"postal_code": "984021903",
"telephone_number": "253-320-5674"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1305 TACOMA AVE S",
"city": "TACOMA",
"state": "WA",
"postal_code": "984021903",
"telephone_number": "253-320-5674"
}
],
"practiceLocations": [
{
"address_1": "1305 Tacoma Ave S",
"address_purpose": "LOCATION",
"city": "Tacoma",
"state": "WA",
"postal_code": "984021903",
"country_code": "US",
"telephone_number": "253-320-5674",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "BRACKMAN",
"first_name": "GRETA",
"middle_name": "CULLEN",
"name_prefix": "Ms.",
"credential": "CG60872398",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2018-06-22",
"last_updated": "2018-06-22",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": "WA",
"license": "CG60872398",
"primary": false
},
{
"code": "171M00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Case Manager/Care Coordinator",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tacoma, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.