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NPI Code Detail

MEDICARE: MRS. CAROLINE GRAY BRINSON

MEDICARE: MRS. CAROLINE GRAY BRINSON
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
1101YM0800XMental Health CounselorA21411NC

General Provider Information

NPI Number : 1700679586
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. CAROLINE GRAY BRINSON
Provider Business Mailing Address
First Line : 4429 OLD TOWNE ST
Second Line :
City : WILMINGTON
State : NC
Zip : 28412-5009
Country : US
Telephone Number : 910-599-8653
Fax Number : 910-599-8653
Provider Business Practice Location Address
First Line : 890 S KERR AVE STE 200
Second Line :
City : WILMINGTON
State : NC
Zip : 28403-4248
Country : US
Telephone Number : 910-599-8653
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/26/2025
Last Update Date : 05/26/2025

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Directions to “ MRS. CAROLINE GRAY BRINSON ” Practice Location

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