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NPI Code Detail

MEDICARE: LORI J BRINKLEY LCSW

MEDICARE: LORI J BRINKLEY LCSW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social WorkerC004200NC

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1015PFOTHERNCBCBS GROUP #
213191OTHERNCBCBS INDIVIDUAL PROV #
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1124047972
Entity Type Code : Individual
Provider Name (Legal Business Name) : LORI J BRINKLEY LCSW
Provider Business Mailing Address
First Line : 5009 WRIGHTSVILLE AVE # A
Second Line :
City : WILMINGTON
State : NC
Zip : 28403-7045
Country : US
Telephone Number : 910-791-5575
Fax Number : 910-791-5576
Provider Business Practice Location Address
First Line : 5009 WRIGHTSVILLE AVE # A
Second Line :
City : WILMINGTON
State : NC
Zip : 28403-7045
Country : US
Telephone Number : 910-791-5575
Fax Number : 910-791-5576
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/19/2006
Last Update Date : 07/09/2007

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Directions to “ LORI J BRINKLEY LCSW” Practice Location

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