Active NPI
Marilyn K Brimmage, MA LPCA LCASA
- Professional Counselor
- Mount Olive, NC
National Provider Identifier
1194368431
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- A15194
- Practice address
- 110 S Center St
Mount Olive, NC 28365-2124 - Phone
- (919) 635-3344
- Fax
- (919) 635-3388
- NPI assigned
- Oct 18, 2019
- Last updated
- Oct 21, 2019
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | LCAS-A-25746 | NC | |
| Professional Counselor | 101YP2500X | A15194 | NC | Primary |
| Prevention Professional | 405300000X | CSAPC-20397 | NC |
Addresses
Primary practice location
110 S Center St
Mount Olive, NC 28365-2124
Mailing address
PO Box 654
Mount Olive, NC 28365-0654
Phone (919) 223-7970
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | www.practicefusion.com | Health Information Exchange (HIE) |
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
| License | State | Type | Specialty |
|---|---|---|---|
| LCAS-A-25746 | NC | MD | Addiction (Substance Use Disorder) Counselor |
| A15194 | NC | MD | Professional Counselor |
| CSAPC-20397 | NC | MD | Prevention Professional |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1571356800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1571616000000",
"number": "1194368431",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 654",
"city": "MOUNT OLIVE",
"state": "NC",
"postal_code": "283650654",
"telephone_number": "919-223-7970"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "110 S CENTER ST",
"city": "MOUNT OLIVE",
"state": "NC",
"postal_code": "283652124",
"telephone_number": "919-635-3344",
"fax_number": "919-635-3388"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRIMMAGE",
"first_name": "MARILYN",
"middle_name": "K",
"name_prefix": "Ms.",
"credential": "MA LPCA LCASA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-10-18",
"last_updated": "2019-10-21",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "NC",
"license": "LCAS-A-25746",
"primary": false
},
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "NC",
"license": "A15194",
"primary": true
},
{
"code": "405300000X",
"taxonomy_group": "",
"desc": "Prevention Professional",
"state": "NC",
"license": "CSAPC-20397",
"primary": false
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "www.practicefusion.com",
"affiliation": "N",
"use": "HIE",
"useDescription": "Health Information Exchange (HIE)",
"contentType": "CSV",
"contentTypeDescription": "CSV",
"address_1": "110 S Center St",
"city": "Mount Olive",
"state": "NC",
"country_code": "US",
"postal_code": "283652124",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Mount Olive, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.