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Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 30 days.

MICHELL BROCKMAN
NPI 1063948685
Counselor - Mental Health in Vancouver, WA

Active since May 02, 2017Opted out of Medicare · through Jan 1, 2028
13023 NE HIGHWAY 99 STE 7, VANCOUVER, WA 98686(253) 201-2436 Get Directions Write a Review

NPPES record last updated: July 17, 2026. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Record update history: Jul 17, 2026, Jan 13, 2026 (2 updates tracked since 2026).

About Michell Brockman NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MICHELL BROCKMAN (NPI 1063948685) is an individual mental health provider in Vancouver, Washington and active in the NPI registry since May 2017. She has opted out of Medicare through January 1, 2028.

NPPES Registry Identity

NPI1063948685
Entity TypeIndividualFemale
Primary Taxonomy101YM0800X
Provider Legal NameMICHELL BROCKMAN
Location Address13023 NE HIGHWAY 99 STE 7Vancouver, WA 98686-2699
Mailing Address13023 Ne Highway 99 Ste 7Vancouver, WA 98686-2699 · (360) 329-2887
Phone(253) 201-2436
Sole ProprietorYes
Enumeration DateMay 2, 2017
Last NPPES UpdateJuly 17, 20262 updates tracked since enumeration
NPPES CertifiedJuly 17, 2026
✔ NPI 1063948685 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · Mental HealthBehavioral Health & Social Service Providers
Taxonomy Code101YM0800X
13023 NE HIGHWAY 99 STE 7, Vancouver, WA 98686
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

ⓘ

Opted out of Medicare

Michell Brockman has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from January 1, 2024 through January 1, 2028.

Opt-Out Effective DateJanuary 1, 2024
Opt-Out In Effect ThroughJanuary 1, 2028Opt-out affidavits renew automatically every two years unless cancelled

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MS. BRIAN MASON AEMT
Emergency Medical Technician, Intermediate
13023 NE HIGHWAY 99 STE 7
VANCOUVER, WA 98686
Clark County (503) 708-1907

Frequently Asked Questions

What is Michell Brockman's NPI number?

The NPI number assigned to this healthcare provider is 1063948685, enumerated as an "individual" on May 02, 2017.

Where is the provider located?

The provider is located at 13023 NE HIGHWAY 99 STE 7 VANCOUVER, WA 98686 and the phone number is (253) 201-2436.

What is the provider's specialty?

Counselor with taxonomy code 101YM0800X and a focus in Mental Health.