Active NPI
Aaron Brink
- Psychologist
- Charlotte, NC
National Provider Identifier
1265147789
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 3904
- Practice address
- 2429 Laburnum Ave
Charlotte, NC 28205-6128 - Phone
- (980) 333-2864
- NPI assigned
- Jan 19, 2023
- Last updated
- Jan 19, 2023
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Psychologist | 103T00000X | 3904 | NC | Primary |
Addresses
Primary practice location
2429 Laburnum Ave
Charlotte, NC 28205-6128
Mailing address
2429 Laburnum Ave
Charlotte, NC 28205-6128
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 |
|---|---|---|---|
| 3904 | NC | MD | Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1674086400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1674086400000",
"number": "1265147789",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2429 LABURNUM AVE",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282056128"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2429 LABURNUM AVE",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282056128",
"telephone_number": "980-333-2864"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRINK",
"first_name": "AARON",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2023-01-19",
"last_updated": "2023-01-19",
"certification_date": "2023-01-19",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "NC",
"license": "3904",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Charlotte, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.