Active NPI
Adrian McBroom
- Mental Health Counselor
- Corvallis, OR
National Provider Identifier
1962934166
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- R4446
- Practice address
- 2747 NW 9TH St
Corvallis, OR 97330-3857 - Phone
- (541) 360-8746
- NPI assigned
- Mar 28, 2017
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | R4446 | OR | |
| Mental Health Counselor | 101YM0800X | R4446 | OR | Primary |
Addresses
Primary practice location
2747 NW 9TH St
Corvallis, OR 97330-3857
Mailing address
3238 54TH Ave NE
Albany, OR 97321-7307
Phone (541) 360-8746
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240709002540 | OR | Practitioner - Mental Health Counselor | 1658816178 | Practice locations: Albany, OR |
Care Compare profile
Medicare Care Compare- Specialty
- Mental Health Counselor
- Education
- Other, 2016
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
Practice addresses (Care Compare)
425 2ND Ave SW
Suite 202a
Albany, OR 97321-2482
Phone (541) 360-8746
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| R4446 | OR | MD | Marriage & Family Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1490659200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1714521600000",
"number": "1962934166",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3238 54TH AVE NE",
"city": "ALBANY",
"state": "OR",
"postal_code": "973217307",
"telephone_number": "541-360-8746"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2747 NW 9TH ST",
"city": "CORVALLIS",
"state": "OR",
"postal_code": "973303857",
"telephone_number": "541-360-8746"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCBROOM",
"first_name": "ADRIAN",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2017-03-28",
"last_updated": "2024-05-01",
"certification_date": "2024-05-01",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "OR",
"license": "R4446",
"primary": false
},
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "OR",
"license": "R4446",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Corvallis, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2024; 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.