Active NPI
Brandy Spencer Rea, LPC
- Professional Counselor
- Philadelphia, MS
National Provider Identifier
1154576700
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 1379
- Practice address
- 502 S Church Ave
Philadelphia, MS 39350-2503 - Phone
- (601) 562-6906
- Fax
- (601) 207-7720
- NPI assigned
- Nov 24, 2008
- 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 |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 1379 | MS | Primary |
Addresses
Primary practice location
502 S Church Ave
Philadelphia, MS 39350-2503
Mailing address
502 S Church Ave
Philadelphia, MS 39350-2503
Phone (601) 562-6906
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 |
|---|---|---|---|
| 1379 | MS | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1227484800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1452556800000",
"number": "1154576700",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "502 S CHURCH AVE",
"city": "PHILADELPHIA",
"state": "MS",
"postal_code": "393502503",
"telephone_number": "601-562-6906",
"fax_number": "601-207-7720"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "502 S CHURCH AVE",
"city": "PHILADELPHIA",
"state": "MS",
"postal_code": "393502503",
"telephone_number": "601-562-6906",
"fax_number": "601-207-7720"
}
],
"practiceLocations": [],
"basic": {
"last_name": "REA",
"first_name": "BRANDY",
"middle_name": "SPENCER",
"name_prefix": "Mrs.",
"credential": "LPC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-11-24",
"last_updated": "2016-01-12",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "MS",
"license": "1379",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Philadelphia, MS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.