Healthcare Provider Details

I. General information

NPI: 1669390852
Provider Name (Legal Business Name): BRILLIANT MINDS MENTAL HEALTH AND WELLNESS, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/07/2026
Last Update Date: 07/07/2026
Certification Date: 07/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

201 E PITT ST STE 204
TARBORO NC
27886-5137
US

IV. Provider business mailing address

201 E PITT ST STE 204
TARBORO NC
27886-5137
US

V. Phone/Fax

Practice location:
  • Phone: 252-376-6841
  • Fax: 252-318-6266
Mailing address:
  • Phone: 252-376-6841
  • Fax: 252-318-6266

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: MRS. CHARNISSA NICOLE BATTS
Title or Position: ADMINISTRATOR
Credential: PMHNP-BC
Phone: 252-376-6841