Active NPI
Brandon Ross Caulder, LCAS-A, LCSWA
- Addiction (Substance Use Disorder) Counselor
- Wilmington, NC
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction (Substance Use Disorder) Counselor
- License
- 28472
- Practice address
- 615 Shipyard Blvd
Wilmington, NC 28412-6431 - Phone
- (910) 343-0145
- Fax
- (910) 341-5779
- NPI assigned
- Aug 29, 2022
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 5
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | MHL-065-011 | NC | |
| Clinical Social Worker | 1041C0700X | P019596 | NC | |
| Clinical Social Worker | 1041C0700X | MHL-065-011 | NC | |
| Case Manager/Care Coordinator | 171M00000X | MHL-065-011 | NC | |
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 28472 | NC | Primary |
Addresses
Primary practice location
615 Shipyard Blvd
Wilmington, NC 28412-6431
Mailing address
615 Shipyard Blvd
Wilmington, NC 28412-6431
Phone (910) 343-0145
Other practice location 1
613 Shipyard Blvd
Wilmington, NC 28412-6492
Phone (910) 202-3860
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 8300416T | Medicaid | NC |
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Mental Health Counselor
- Education
- Other, 2022
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1442 Military Cutoff Rd
Unit B
Wilmington, NC 28403-3605
Phone (910) 270-9995
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 28472 | NC | MD | Addiction (Substance Use Disorder) Counselor |
| P019596 | NC | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Anchor Psychological & Counseling Services PLLC | Current | Accepting new patients |
Locations
16581 US Highway 17
Ste 600
Hampstead, NC 28443
Phone (910) 270-9995
1442 Military Cutoff Rd
Unit B
Wilmington, NC 28403
Phone (252) 822-4150
Organizations & group practices 1
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.
-
- Clinical Psychologist
- Hampstead, NC
- NPI 1114124401
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1661731200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1692835200000",
"number": "1154041523",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "615 SHIPYARD BLVD",
"city": "WILMINGTON",
"state": "NC",
"postal_code": "284126431",
"telephone_number": "910-343-0145"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "615 SHIPYARD BLVD",
"city": "WILMINGTON",
"state": "NC",
"postal_code": "284126431",
"telephone_number": "910-343-0145",
"fax_number": "910-341-5779"
}
],
"practiceLocations": [
{
"address_1": "613 Shipyard Blvd",
"address_purpose": "LOCATION",
"city": "Wilmington",
"state": "NC",
"postal_code": "284126492",
"country_code": "US",
"telephone_number": "910-202-3860",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "CAULDER",
"first_name": "BRANDON",
"middle_name": "ROSS",
"credential": "LCAS-A, LCSWA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2022-08-29",
"last_updated": "2023-08-24",
"certification_date": "2023-08-24",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "NC",
"license": "MHL-065-011",
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "NC",
"license": "P019596",
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "NC",
"license": "MHL-065-011",
"primary": false
},
{
"code": "171M00000X",
"taxonomy_group": "",
"desc": "Case Manager/Care Coordinator",
"state": "NC",
"license": "MHL-065-011",
"primary": false
},
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "NC",
"license": "28472",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "8300416T",
"state": "NC"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Wilmington, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2023; 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.