Active NPI
Mary Brandenburg, L.M.H.C., N.C.C.
- Mental Health Counselor
- Kenmore, WA
National Provider Identifier
1760813828
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- LH00010763
- Practice address
- 18737 68TH Ave NE
Kenmore, WA 98028-2606 - Phone
- (425) 939-1490
- NPI assigned
- Nov 27, 2013
- Last updated
- Nov 27, 2013
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | LH00010763 | WA | Primary |
Addresses
Primary practice location
18737 68TH Ave NE
Kenmore, WA 98028-2606
Mailing address
12703 NE 142ND CT
Kirkland, WA 98034-1514
Phone (425) 591-6751
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 |
|---|---|---|---|
| LH00010763 | WA | MD | Mental Health Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Cedar Park Counseling Network | Mental Health | Past | Accepting new patients |
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1385510400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1385510400000",
"number": "1760813828",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12703 NE 142ND CT",
"city": "KIRKLAND",
"state": "WA",
"postal_code": "980341514",
"telephone_number": "425-591-6751"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "18737 68TH AVE NE",
"city": "KENMORE",
"state": "WA",
"postal_code": "980282606",
"telephone_number": "425-939-1490"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRANDENBURG",
"first_name": "MARY",
"credential": "L.M.H.C., N.C.C.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2013-11-27",
"last_updated": "2013-11-27",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "WA",
"license": "LH00010763",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Kenmore, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.