Individual provider Active NPI

Michael Bricker, MS, BS, CADC II

  • Professional Counselor
  • Klamath Falls, OR
National Provider Identifier
1891983607
Registry record updated Nov 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
C2949 Issued in OR
Practice address
2545 N Eldorado Ave
Klamath Falls, OR 97601-6423
Phone
(541) 883-3471
Fax
(541) 883-3524
NPI assigned
Oct 5, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 27, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X C2949 OR Primary
Mental Health Counselor 101YM0800X AK300 AK

Addresses

Primary practice location

2545 N Eldorado Ave
Klamath Falls, OR 97601-6423

Mailing address

2545 N Eldorado Ave
Klamath Falls, OR 97601-6423
Phone (541) 883-3471

Other identifiers 1

IdentifierTypeStateIssuer
090450MedicaidOR

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20241219003422 OR Practitioner - Mental Health Counselor 6507393162 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

18765 SW Boones Ferry Rd
Suite 100
Tualatin, OR 97062-8607
Phone (503) 612-1000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Bachelor of Science, Master of Science

State licenses

LicenseStateTypeSpecialty
AK300AKMDMental Health Counselor
C2949ORMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Western Psychological and Counseling Services LLC Mental Health CurrentSince Sep 30, 2024 Accepting new patients
Western Psychological and Counseling Services LLC Mental Health CurrentSince Sep 30, 2024 Accepting new patients

Locations

4800 N Scottsdale Rd
Ste 2500
Scottsdale, AZ 85251
Phone (253) 346-0392

44 Club Rd
Ste 200
Eugene, OR 97401
Phone (254) 393-5983

880 82nd Dr
Gladstone, OR 97027
Phone (503) 626-9494

18765 SW Boones Ferry Rd
Ste 100
Tualatin, OR 97062
Phone (503) 612-1000

Interoperability endpoints

  • Direct secure messaging: lifestancehealth.michaelbricker@151848.advancedmd-direct.com

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1191542400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732665600000",
    "number": "1891983607",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2545 N ELDORADO AVE",
            "city": "KLAMATH FALLS",
            "state": "OR",
            "postal_code": "976016423",
            "telephone_number": "541-883-3471",
            "fax_number": "541-883-3524"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2545 N ELDORADO AVE",
            "city": "KLAMATH FALLS",
            "state": "OR",
            "postal_code": "976016423",
            "telephone_number": "541-883-3471",
            "fax_number": "541-883-3524"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRICKER",
        "first_name": "MICHAEL",
        "credential": "MS, BS, CADC II",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-10-05",
        "last_updated": "2024-11-27",
        "certification_date": "2024-11-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "OR",
            "license": "C2949",
            "primary": true
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "AK",
            "license": "AK300",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "090450",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Klamath Falls, OR

Sources for this page

Verify at the official NPI Registry.