Active NPI
Nicole Renee Breesnee, CDP
- Counselor
- Spokane, WA
National Provider Identifier
1760953384
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counselor
- License
- CO60709233
- Practice address
- 2308 W. 3Rd Ave
Spokane, WA 99201 - Phone
- (509) 624-1244
- Fax
- (509) 624-6240
- NPI assigned
- Dec 7, 2018
- Last updated
- Jul 9, 2019
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | CO60709233 | WA | Primary |
Addresses
Primary practice location
2308 W. 3Rd Ave
Spokane, WA 99201
Mailing address
12715 E Mission Ave
Spokane Valley, WA 99216-1027
Phone (509) 232-5766
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2077844 | Medicaid | WA |
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 |
|---|---|---|---|
| CO60709233 | WA | MD | Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| New Horizon Care Centers, Inc. | Past | Accepting new patients | |
| New Horizon Care Center, Inc. | Past | Accepting new patients | |
| American Behavioral Health Systems, Inc. | Past | Accepting new patients | |
| American Behavioral Health Systems, Inc. | Past | Accepting new patients |
Organizations & group practices 4
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.
-
- Substance Abuse Rehabilitation Facility
- Chehalis, WA
- NPI 1598123226
-
- Substance Abuse Rehabilitation Facility
- Spokane Valley, WA
- NPI 1962991661
-
- Substance Abuse Rehabilitation Facility
- Spokane, WA
- NPI 1538388665
-
dba New Horizon Counseling Services
- Community/Behavioral Health Agency
- Spokane Valley, WA
- NPI 1518186600
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1544140800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1562630400000",
"number": "1760953384",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12715 E MISSION AVE",
"city": "SPOKANE VALLEY",
"state": "WA",
"postal_code": "992161027",
"telephone_number": "509-232-5766",
"fax_number": "509-321-5472"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2308 W. 3RD AVE",
"city": "SPOKANE",
"state": "WA",
"postal_code": "99201",
"telephone_number": "509-624-1244",
"fax_number": "509-624-6240"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BREESNEE",
"first_name": "NICOLE",
"middle_name": "RENEE",
"credential": "CDP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-12-07",
"last_updated": "2019-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": "WA",
"license": "CO60709233",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "2077844",
"state": "WA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Spokane, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.