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MIKE W BROCKMAN CADC II/QMHA-I
NPI 1073641064
Counselor - Addiction (Substance Use Disorder) in Portland, OR

Active since March 01, 2007
1631 SW COLUMBIA ST, PORTLAND, OR 97201(503) 231-2641(503) 231-1654 Get Directions Write a Review

NPPES record last updated: July 1, 2024. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Jul 1, 2024, May 27, 2020, Jun 4, 2019 and 1 more (4 updates tracked since 2017).

About Mike W Brockman Cadc Ii/qmha-i NPPES

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

MIKE W BROCKMAN CADC II/QMHA-I (NPI 1073641064) is an individual addiction (substance use disorder) provider in Portland, Oregon, licensed in Oregon (15-10-21) and active in the NPI registry since March 2007.

NPPES Registry Identity

NPI1073641064
Entity TypeIndividualMale
Primary Taxonomy101YA0400X
Provider Legal NameMIKE W BROCKMANCredential: CADC II/QMHA-I
Location Address1631 SW COLUMBIA STPortland, OR 97201-6025
Mailing Address1776 Sw Madison StPortland, OR 97205-1715 · (971) 386-2278 · Fax (503) 224-4494
Phone(503) 231-2641
Fax(503) 231-1654
Sole ProprietorNo
Enumeration DateMarch 1, 2007
Last NPPES UpdateJuly 1, 20244 updates tracked since enumeration
NPPES CertifiedJuly 1, 2024
✔ NPI 1073641064 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyCounselor · Addiction (Substance Use Disorder)Behavioral Health & Social Service Providers
Taxonomy Code101YA0400X
License✔ Licensed in OR · 15-10-21
Also ListedCounselor · Mental HealthTaxonomy 101YM0800X · License 19-QMHA-I-01468 (OR)
1631 SW COLUMBIA ST, Portland, OR 97201
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Other Names 1

Other Name (5)Michael W Brockman Cadc Ii/qmha-i

Other Identifiers 2

Medicaid500694604OR
Medicaid500777728OR

Other Providers at the Same Location NPPES 20

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

AMBER C LEWIS CRM/PSS
Counselor (Addiction (Substance Use Disorder))
1631 SW COLUMBIA ST
PORTLAND, OR 97201
Multnomah County (503) 231-2641
JESSICA L SPAIN CADC I/QMHA-R
Counselor (Addiction (Substance Use Disorder))
1631 SW COLUMBIA ST
PORTLAND, OR 97201
Multnomah County (503) 231-2641
NICOLE MARIE WILLIAMS CADC II/QMHA-I
Counselor (Mental Health)
1631 SW COLUMBIA ST
PORTLAND, OR 97201
Multnomah County (503) 231-2641
ANDULIA WHITE ELK CADCI
Counselor (Addiction (Substance Use Disorder))
1631 SW COLUMBIA ST
PORTLAND, OR 97201
Multnomah County (503) 231-2641
OULU MARIE NOONAN CADC-R
Rehabilitation Practitioner
1631 SW COLUMBIA ST
PORTLAND, OR 97201
Multnomah County (503) 231-2641
PEGGY LACOMBE CADCII
Counselor (Addiction (Substance Use Disorder))
1631 SW COLUMBIA ST
PORTLAND, OR 97201
Multnomah County (503) 231-2641
NAIMAH JOHNSON QMHA-I
Counselor (Mental Health)
1631 SW COLUMBIA ST
PORTLAND, OR 97201
Multnomah County (503) 231-2641
PAMELA YOUNG RN
Registered Nurse
1631 SW COLUMBIA ST
PORTLAND, OR 97201
Multnomah County (503) 231-2641

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Mike Brockman's NPI number?

The NPI number for Mike Brockman is 1073641064. It was assigned to this individual provider in the NPPES registry on March 1, 2007. The provider is also known as Michael W Brockman Cadc Ii/Qmha-I.

Where is Mike Brockman located?

Mike Brockman practices at 1631 SW Columbia St, Portland, OR 97201. The listed phone number is (503) 231-2641.

What is Mike Brockman's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Addiction (Substance Use Disorder), with taxonomy code 101YA0400X.

When was this NPI record last updated?

The NPPES record for Mike Brockman was last updated on July 1, 2024. NPI Profile syncs with the weekly NPPES data releases published by CMS.