Healthcare Provider Details

I. General information

NPI: 1912894080
Provider Name (Legal Business Name): BERMUDA RUN COUNSELING, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/21/2025
Last Update Date: 06/21/2025
Certification Date: 06/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

106 YORK WAY
ADVANCE NC
27006-7666
US

IV. Provider business mailing address

222 BROADMOOR DR
ADVANCE NC
27006-6957
US

V. Phone/Fax

Practice location:
  • Phone: 336-270-9339
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: BRITTANY MERZ
Title or Position: OWNER/THERAPIST
Credential:
Phone: 336-407-4636