Keisha Hinton Bryan, LCSW, LCAS

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Practice address

1008 Big Oak CT Ste F
Knightdale, NC 27545-6566

Phone

(919) 520-9392

Fax

(919) 261-1675

NPI assigned

Jan 18, 2008

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Keisha Michelle Hinton Former name

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

Specialty

Clinical Social Worker

Education

Other, 2006

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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

• Wake Renewal Counseling, PLLC

  • Clinical Social Worker
  • Knightdale, NC
  • NPI 1205276599
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1200614400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1372636800000",
    "number": "1073799227",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4905 RAVELSTONE CT",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276102897",
            "telephone_number": "919-520-9392",
            "fax_number": "919-261-1675"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1008 BIG OAK CT STE F",
            "city": "KNIGHTDALE",
            "state": "NC",
            "postal_code": "275456566",
            "telephone_number": "919-520-9392",
            "fax_number": "919-261-1675"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRYAN",
        "first_name": "KEISHA",
        "middle_name": "HINTON",
        "credential": "LCSW, LCAS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-01-18",
        "last_updated": "2013-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6112015",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KEISHA",
            "last_name": "HINTON",
            "middle_name": "MICHELLE",
            "credential": "LCSW, LCAS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Pamela Renee Bredy, RN, BSN, PMHNP-BC
• Anna Briggery
• Dipa Desai Brown, PTA
• Shanita Shantelle Brown, PHD, LCMHC, NCC
• Patrick Gregory Bruff, NP
• Christopher Scott Buchanan, PHARM D.
• Sara A Buchenberger, MA, LCMHCA, NCC
• Chrystal Althea Buckrham, SLP
• Nicole Pederson Burnett, DPT
• Amanda Cadarette, RDN, LDN, CLC

• Clinical Social Worker in Knightdale, NC
• Providers in Knightdale, NC by specialty
• Clinical Social Worker in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.