Individual provider Active NPI

Roberta Denise Brinkley, LCMHC, LCAS-A

  • Mental Health Counselor
  • Greensboro, NC
National Provider Identifier
1174997811
Registry record updated Sep 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
11985 Issued in NC
Practice address
5709 W Friendly Ave Ste a
Greensboro, NC 27410-4112
Phone
(336) 986-9787
Fax
(336) 232-1516
NPI assigned
Nov 18, 2015
Last updated
Sep 23, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 23, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X 11985 NC
Mental Health Counselor 101YM0800X 11985 NC Primary
Professional Counselor 101YP2500X 11985 NC

Addresses

Primary practice location

5709 W Friendly Ave Ste a
Greensboro, NC 27410-4112

Mailing address

5709 W Friendly Ave Ste a
Greensboro, NC 27410-4112
Phone (252) 955-2354

Other identifiers 1

IdentifierTypeStateIssuer
1174997811MedicaidNC

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20251028001276 NC Practitioner - Mental Health Counselor 8022507300 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2014
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

3300 Peninsula Dr
Jamestown, NC 27282-8719

5709 W Friendly Ave
Suite a
Greensboro, NC 27410-4112

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
11985NCMDCounselor

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Health Cares of NC LLC CurrentSince Mar 20, 2025 Accepting new patients
Triad Family and Childrens Services LLC CurrentSince Jun 14, 2025 Accepting new patients
Provident Health Care LLC Current Accepting new patients

Locations

5709 W Friendly Ave
#A
Greensboro, NC 27410
Phone (252) 955-2354

Organizations & group practices 6

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

NPI Registry JSON

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

{
    "created_epoch": "1447804800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1758585600000",
    "number": "1174997811",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5709 W FRIENDLY AVE STE A",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274104112",
            "telephone_number": "252-955-2354"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5709 W FRIENDLY AVE STE A",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274104112",
            "telephone_number": "336-986-9787",
            "fax_number": "336-232-1516"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRINKLEY",
        "first_name": "ROBERTA",
        "middle_name": "DENISE",
        "credential": "LCMHC, LCAS-A",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-11-18",
        "last_updated": "2025-09-23",
        "certification_date": "2025-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "NC",
            "license": "11985",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NC",
            "license": "11985",
            "primary": true
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NC",
            "license": "11985",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1174997811",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Greensboro, NC

Sources for this page

Verify at the official NPI Registry.