Healthcare Provider Details

I. General information

NPI: 1477006021
Provider Name (Legal Business Name): OCEANSIDE FAMILY COUNSELING AND RESOURCE CENTER, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/01/2016
Last Update Date: 08/17/2026
Certification Date: 08/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1590 VINSON BLVD
BRUNSWICK NC
28424
US

IV. Provider business mailing address

8253 OAK ABBEY TRL NE
LELAND NC
28451-4253
US

V. Phone/Fax

Practice location:
  • Phone: 910-685-1175
  • Fax: 910-970-7213
Mailing address:
  • Phone: 910-685-1175
  • Fax: 910-970-7213

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number20495
License Number StateNC
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberA11182
License Number StateNC

VIII. Authorized Official

Name: DEANNA LYNN BROWN-JOHNSON
Title or Position: OWNER/CLINICAL DIRECTOR
Credential: LCMCHS/LCAS
Phone: 910-234-6031