Individual provider Active NPI

Brianne Chauvigne Reedy, LCMHC, NCC

  • Mental Health Counselor
  • Mooresville, NC
National Provider Identifier
1316442908
Registry record updated Jan 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
13776 Issued in NC
Practice address
122 Gateway Blvd Ste C
Mooresville, NC 28117-5544
Phone
(704) 360-3637
NPI assigned
Mar 27, 2018
Last updated
Jan 12, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 12, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X
Mental Health Counselor 101YM0800X 13776 NC Primary

Addresses

Primary practice location

122 Gateway Blvd Ste C
Mooresville, NC 28117-5544

Mailing address

122 Gateway Blvd Ste C
Mooresville, NC 28117-5544
Phone (704) 463-0300

Other names 1

  • Brianne Landis Chauvigne Former name

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
I20240126000222 NC Practitioner - Mental Health Counselor 3678926615 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Integrative Wellness Solutions PLLCGroup PAC ID 8022341494, 143 clinicians

Practice addresses (Care Compare)

122 Gateway Blvd
Suite C
Mooresville, NC 28117-5544
Phone (704) 360-3637

3625 N Elm St
Suite 130
Greensboro, NC 27455-2604
Phone (704) 360-3637

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
13776NCMDPediatric Dentist

Interoperability endpoints

  • Direct secure messaging: integrativewellnesssolutions.briannechauvigne@146232.advancedmd-direct.com

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, 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": "1522108800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705017600000",
    "number": "1316442908",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "122 GATEWAY BLVD STE C",
            "city": "MOORESVILLE",
            "state": "NC",
            "postal_code": "281175544",
            "telephone_number": "704-463-0300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "122 GATEWAY BLVD STE C",
            "city": "MOORESVILLE",
            "state": "NC",
            "postal_code": "281175544",
            "telephone_number": "704-360-3637"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REEDY",
        "first_name": "BRIANNE",
        "middle_name": "CHAUVIGNE",
        "credential": "LCMHC, NCC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-03-27",
        "last_updated": "2024-01-12",
        "certification_date": "2024-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NC",
            "license": "13776",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BRIANNE",
            "last_name": "CHAUVIGNE",
            "middle_name": "LANDIS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Mooresville, NC

Sources for this page

Verify at the official NPI Registry.