Individual provider Active NPI

Brandy N Gresham, MA, CAADC, CSAC

  • Mental Health Counselor
  • Norfolk, VA
National Provider Identifier
1164933800
Registry record updated May 14, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Practice address
2461 E Little Creek Rd
Norfolk, VA 23518-1294
Phone
(860) 716-4970
NPI assigned
Oct 20, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 14, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X Primary
Addiction (Substance Use Disorder) Counselor 101YA0400X 0710103174 VA

Addresses

Primary practice location

2461 E Little Creek Rd
Norfolk, VA 23518-1294

Mailing address

1634 Sheppard Ave
Norfolk, VA 23518-2933
Phone (860) 716-4970

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
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
0710103174VAMDAddiction (Substance Use Disorder) Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Morning'S Light LLC Mental Health CurrentSince Jul 4, 2021 Accepting new patients

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.

NPI Registry JSON

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

{
    "created_epoch": "1508457600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620950400000",
    "number": "1164933800",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1634 SHEPPARD AVE",
            "city": "NORFOLK",
            "state": "VA",
            "postal_code": "235182933",
            "telephone_number": "860-716-4970"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2461 E LITTLE CREEK RD",
            "city": "NORFOLK",
            "state": "VA",
            "postal_code": "235181294",
            "telephone_number": "860-716-4970"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRESHAM",
        "first_name": "BRANDY",
        "middle_name": "N",
        "name_prefix": "Ms.",
        "credential": "MA, CAADC, CSAC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-10-20",
        "last_updated": "2021-05-14",
        "certification_date": "2021-05-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "VA",
            "license": "0710103174",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Norfolk, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.