Julie Brandenburg, PHD, HSPP

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

071.010269 Issued in IL

Practice address

1255 W 18TH St
Chicago, IL 60608-3242

Phone

(773) 622-6218

Fax

(773) 622-7440

NPI assigned

Jun 6, 2013

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

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

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

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.

• Centro Castillo for Personal and Family Wellbeing, LLC

  • Clinical Psychologist
  • Chicago, IL
  • NPI 1598942484
  NPD (past)

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

{
    "created_epoch": "1370476800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1585526400000",
    "number": "1962840405",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6250 W NORTH AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606393861",
            "telephone_number": "773-622-6218",
            "fax_number": "773-622-7440"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1255 W 18TH ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606083242",
            "telephone_number": "773-622-6218",
            "fax_number": "773-622-7440"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6250 W North Ave",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606393861",
            "country_code": "US",
            "telephone_number": "773-622-6218",
            "fax_number": "773-622-7440",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3166 N Lincoln Ave Ste 224",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606573119",
            "country_code": "US",
            "telephone_number": "773-622-6218",
            "fax_number": "773-622-7440",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BRANDENBURG",
        "first_name": "JULIE",
        "credential": "PHD, HSPP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-06-06",
        "last_updated": "2020-03-30",
        "certification_date": "2020-03-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "IN",
            "license": "20042618A",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IL",
            "license": "071.010269",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Pamela Anne Brand, M.A., PSY.D., LMFT
• Holley Marie Brandchaft-White, LCSW
• Elizabeth Brandel, PT
• Taylor Jordan Brandenberger
• Kathryn Brandenborg-Conti, PSY.D., MA
• Molly N Brandenburg, DPT
• Ryan Brander, ATC
• Victoria Brander, MD
• Cassandra Margaret Brandes, PHD
• Amanda Brandimore

• Clinical Psychologist in Chicago, IL
• Providers in Chicago, IL by specialty
• Clinical Psychologist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2020; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.