Lori Kim Brill, PSYD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

4055 Issued in AZ

Practice address

4150 W Peoria Ave
Ste 133
Phoenix, AZ 85029-3900

Phone

(602) 910-0526

NPI assigned

Sep 12, 2009

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other names 1

• Lori Kim Lichte-Brill Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1252713600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1432425600000",
    "number": "1902139603",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3215 W RAPALO RD",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850862213",
            "telephone_number": "602-910-0526"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4150 W PEORIA AVE",
            "address_2": "STE 133",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850293900",
            "telephone_number": "602-910-0526"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRILL",
        "first_name": "LORI",
        "middle_name": "KIM",
        "credential": "PSYD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-09-12",
        "last_updated": "2015-05-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "AZ",
            "license": "4055",
            "primary": true
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "UT",
            "license": "7796313-2501",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LORI",
            "last_name": "LICHTE-BRILL",
            "middle_name": "KIM",
            "credential": "PSY.D.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Brightmind Behavioral Health, LLC
• Brightside ABA Az LLC
• Brightstar Services LLC
• Megan Briglia
• Leah Brignall, LAC
• Frederick Joseph Brillas, D.C.
• Brilliant Arrows LLC
• Brilliant Care LLC
• Brilliant Mind Wellness LLC
• Sean Joseph Brimacombe, MD

• Clinical Psychologist in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Clinical Psychologist in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.