Jessica Brunelle, LPC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Practice address

831 NW Council Dr Ste 300
Gresham, OR 97030-3725

Phone

(503) 258-4281

NPI assigned

Oct 24, 2012

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in OR

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Mental Health Counselor

Education

Other, 2012

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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.

• Brightways Counseling Group LLC

  • Group Psychotherapy Psychologist
  • Redmond, OR
  • NPI 1689191165
  Medicare reassignment

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

{
    "created_epoch": "1351036800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658880000000",
    "number": "1770836934",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "831 NW COUNCIL DR STE 300",
            "city": "GRESHAM",
            "state": "OR",
            "postal_code": "970303725",
            "telephone_number": "503-258-4281"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "831 NW COUNCIL DR STE 300",
            "city": "GRESHAM",
            "state": "OR",
            "postal_code": "970303725",
            "telephone_number": "503-258-4281"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRUNELLE",
        "first_name": "JESSICA",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-10-24",
        "last_updated": "2022-07-27",
        "certification_date": "2022-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "274147",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Julie Rae Brown, OTA/L
• Laura Marie F Brown, MD
• Matthew Brown, ND
• Erica Bruce, PT, DPT
• Kindi Elaine Brumbaugh, MSW
• Cathy J Brunton, CHN
• Melody Rose Bryden
• Ava Buchanan
• Timothy Buckley, BA
• Christy Richter Buckman, MD

• Mental Health Counselor in Gresham, OR
• Providers in Gresham, OR by specialty
• Mental Health Counselor in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.