Active NPI
Ruby Brake
- Mental Health Counselor
- Winston Salem, NC
National Provider Identifier
1023836319
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- A20516
- Practice address
- 3469 Borum Dr
Winston Salem, NC 27107-4501 - Phone
- (704) 441-3230
- NPI assigned
- Sep 26, 2024
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | A20516 | NC | Primary |
Addresses
Primary practice location
3469 Borum Dr
Winston Salem, NC 27107-4501
Mailing address
3469 Borum Dr
Winston Salem, NC 27107-4501
Phone (704) 441-3230
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A20516 | NC | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1727308800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1727308800000",
"number": "1023836319",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3469 BORUM DR",
"city": "WINSTON SALEM",
"state": "NC",
"postal_code": "271074501",
"telephone_number": "704-441-3230"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3469 BORUM DR",
"city": "WINSTON SALEM",
"state": "NC",
"postal_code": "271074501",
"telephone_number": "704-441-3230"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRAKE",
"first_name": "RUBY",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2024-09-26",
"last_updated": "2024-09-26",
"certification_date": "2024-09-26",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "NC",
"license": "A20516",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Winston Salem, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.