NPIMap

Individual provider Active NPI

Christa Brandenburg, LPC, CRC, NCAC II

  • Mental Health Counselor
  • McMinnville, OR
National Provider Identifier
1639317506
Registry record updated May 21, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
C3701 Issued in OR
Practice address
627 NE Evans St
McMinnville, OR 97128-3923
Phone
(503) 434-7523
NPI assigned
Jan 29, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 21, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 90-09-04 OR
Mental Health Counselor 101YM0800X C3701 OR Primary

Addresses

Primary practice location

627 NE Evans St
McMinnville, OR 97128-3923

Mailing address

627 NE Evans St
McMinnville, OR 97128-3923
Phone (503) 434-7523

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
C3701ORMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1233187200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1432166400000",
    "number": "1639317506",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "627 NE EVANS ST",
            "city": "MCMINNVILLE",
            "state": "OR",
            "postal_code": "971283923",
            "telephone_number": "503-434-7523"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "627 NE EVANS ST",
            "city": "MCMINNVILLE",
            "state": "OR",
            "postal_code": "971283923",
            "telephone_number": "503-434-7523"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRANDENBURG",
        "first_name": "CHRISTA",
        "credential": "LPC, CRC, NCAC II",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-01-29",
        "last_updated": "2015-05-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "OR",
            "license": "90-09-04",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "OR",
            "license": "C3701",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in McMinnville, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2015; 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.