Kelly Brachman, MSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Practice address

1701 E Evergreen Blvd
Vancouver, WA 98661-4289

Phone

(360) 605-2629

NPI assigned

Jun 19, 2015

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Real Life Community Behavioral Health PLLC

  • Mental Health Counselor
  • Vancouver, WA
  • NPI 1952063265

  Mental Health

  NPD
• Catholic Community Services of Western Washington

  • Community/Behavioral Health Agency
  • Vancouver, WA
  • NPI 1558593350
  NPD (past)

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

{
    "created_epoch": "1434672000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1682380800000",
    "number": "1962884478",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16420 SE MCGILLIVRAY BLVD STE 103-535",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986833461",
            "telephone_number": "360-605-2629"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1701 E EVERGREEN BLVD",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986614289",
            "telephone_number": "360-605-2629"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRACHMAN",
        "first_name": "KELLY",
        "credential": "MSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-06-19",
        "last_updated": "2023-04-25",
        "certification_date": "2023-04-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WA",
            "license": "LW60794656",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kirah Boynton-Brown, DPT, PT
• Brittani Nicole Bozeman, MA
• BR Anesthesia-Wa PLLC
• Katherine Braaten, LMT
• Ariana Brace
• Kelly Sue Bracken, PMHNP
• Kristy Bracken, LMP
• Rachael M Bradbury, BA, AAC
• Chloe Bradley
• Helen L Bradley

• All providers in Vancouver, WA
• Clinical Social Worker in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2023; 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.