Active NPI
Brooke Noelle Wahlund, MA
- Marriage & Family Therapist
- McKinleyville, CA
National Provider Identifier
1760096234
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- 120111
- Practice address
- 1560 Betty CT
McKinleyville, CA 95519-4178 - Phone
- (916) 512-8420
- NPI assigned
- Sep 2, 2020
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 120111 | CA | |
| Marriage & Family Therapist | 106H00000X | 120111 | CA | Primary |
Addresses
Primary practice location
1560 Betty CT
McKinleyville, CA 95519-4178
Mailing address
1560 Betty CT
McKinleyville, CA 95519-4178
Phone (707) 839-1933
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
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 120111 | CA | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1599004800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1696464000000",
"number": "1760096234",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1560 BETTY CT",
"city": "MCKINLEYVILLE",
"state": "CA",
"postal_code": "955194178",
"telephone_number": "707-839-1933"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1560 BETTY CT",
"city": "MCKINLEYVILLE",
"state": "CA",
"postal_code": "955194178",
"telephone_number": "916-512-8420"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WAHLUND",
"first_name": "BROOKE",
"middle_name": "NOELLE",
"credential": "MA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-09-02",
"last_updated": "2023-10-05",
"certification_date": "2023-10-02",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "CA",
"license": "120111",
"primary": false
},
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "CA",
"license": "120111",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in McKinleyville, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.