Individual provider Active NPI

Cierra Latreece Brabham, LPC, LCMHC

  • Mental Health Counselor
  • Columbia, SC
National Provider Identifier
1235507054
Registry record updated Oct 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
6032 Issued in SC
Practice address
104 Firebridge Rd
Columbia, SC 29223-5101
Phone
(803) 269-0824
NPI assigned
Sep 10, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 29, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 6032 SC Primary

Addresses

Primary practice location

104 Firebridge Rd
Columbia, SC 29223-5101

Mailing address

310 Ross Rd Apt 6I
Columbia, SC 29223-4915
Phone (803) 269-0824

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC, NC2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20240522002221 SC Practitioner - Mental Health Counselor 8527400530
I20250116002151 NC Practitioner - Mental Health Counselor 8527400530 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6032SCMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Carolinas Medical Center CurrentSince Oct 11, 2024 Accepting new patients
Carolinas Medical Center Current Accepting new patients
Carolinas Medical Center CurrentSince Oct 11, 2024 Accepting new patients
Thrive Counseling LLC Mental Health CurrentSince May 3, 2024 Accepting new patients

Locations

501 Billingsley Rd
Charlotte, NC 28211
Phone (704) 358-2700

1000 Blythe Blvd
Charlotte, NC 28203
Phone (704) 351-3791

113 Executive Pointe Blvd
Ste 104
Columbia, SC 29210
Phone (803) 477-3736

4975 Lacross Rd
Ste 351
North Charleston, SC 29406
Phone (800) 309-1159

1000 Jefferson St
Ste 2C
Lynchburg, VA 24504
Phone (434) 528-3263

Organizations & group practices 4

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": "1441843200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730160000000",
    "number": "1235507054",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "310 ROSS RD APT 6I",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292234915",
            "telephone_number": "803-269-0824"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "104 FIREBRIDGE RD",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292235101",
            "telephone_number": "803-269-0824"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRABHAM",
        "first_name": "CIERRA",
        "middle_name": "LATREECE",
        "credential": "LPC, LCMHC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-09-10",
        "last_updated": "2024-10-29",
        "certification_date": "2024-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "SC",
            "license": "6032",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, SC

Sources for this page

Verify at the official NPI Registry.