Individual provider Active NPI

Andrea Breech Hunt, PSY.D.

  • Psychologist
  • Wilmington, NC
National Provider Identifier
1023301959
Registry record updated Dec 14, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
4906 Issued in NC
Practice address
2202 Wrightsville Ave Ste 211
Wilmington, NC 28403-3052
Phone
(717) 802-1380
Fax
(910) 833-8371
NPI assigned
May 25, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 14, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X PS017005 PA
Psychologist 103T00000X 4906 NC Primary

Addresses

Primary practice location

2202 Wrightsville Ave Ste 211
Wilmington, NC 28403-3052

Mailing address

2202 Wrightsville Ave Ste 211
Wilmington, NC 28403-3052
Phone (717) 802-1380

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160211002275 NC Practitioner - Clinical Psychologist 9830493824 Practice locations: Wilmington, NC

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2202 Wrightsville Ave
Suite 211
Wilmington, NC 28403-3052
Phone (910) 833-8370

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PS017005PAMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Lifesource of North Carolina CurrentSince Jan 1, 2016 Accepting new patients
Lifesource of North Carolina Psychologist CurrentSince Jan 1, 2016 Accepting new patients
Jenifer Phelps, PLLC PastSince Mar 1, 2021 Accepting new patients

Locations

3205 Randall Pkwy
Ste 105
Wilmington, NC 28403
Phone (910) 338-2880

Interoperability endpoints

  • Direct secure messaging: andrea.hunt@the-healing-partnership.direct.kno2fy.com

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1306281600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639440000000",
    "number": "1023301959",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2202 WRIGHTSVILLE AVE STE 211",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284033052",
            "telephone_number": "717-802-1380",
            "fax_number": "910-833-8371"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2202 WRIGHTSVILLE AVE STE 211",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284033052",
            "telephone_number": "717-802-1380",
            "fax_number": "910-833-8371"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUNT",
        "first_name": "ANDREA",
        "middle_name": "BREECH",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-05-25",
        "last_updated": "2021-12-14",
        "certification_date": "2021-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "PA",
            "license": "PS017005",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NC",
            "license": "4906",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wilmington, NC

Sources for this page

Verify at the official NPI Registry.