Individual provider Active NPI

Rene Gregston Brathwaite, LPCMH, ICCDP-D, NCC

  • Mental Health Counselor
  • Newark, DE
National Provider Identifier
1316461072
Registry record updated Jan 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
PC-0000813 Issued in DE
Practice address
262 Chapman Rd Ste 203
Newark, DE 19702-5442
Phone
(302) 689-3562
Fax
(302) 294-1757
NPI assigned
Aug 2, 2017
Last updated
Jan 9, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 9, 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 PC-0000813 DE Primary

Addresses

Primary practice location

262 Chapman Rd Ste 203
Newark, DE 19702-5442

Mailing address

204 Shetland Dr
New Castle, DE 19720-8832
Phone (917) 617-7839

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DE
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
I20240712000173 DE Practitioner - Mental Health Counselor 2466997762 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

262 Chapman Rd
Suite 203
Newark, DE 19702-5442
Phone (302) 689-3562

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PC-0000813DEMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Turning Corners Inc Mental Health CurrentSince Oct 18, 2018 Accepting new patients
Turning Corners Inc CurrentSince Jan 21, 2024 Accepting new patients
A Center for Mental Wellness, Inc. Mental Health PastSince May 4, 2009 Accepting new patients

Locations

262 Chapman Rd
Ste 203
Newark, DE 19702
Phone (302) 689-3562

700 Barksdale Rd
Ste 6
Newark, DE 19711
Phone (302) 294-6950

Organizations & group practices 3

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": "1501632000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704758400000",
    "number": "1316461072",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "204 SHETLAND DR",
            "city": "NEW CASTLE",
            "state": "DE",
            "postal_code": "197208832",
            "telephone_number": "917-617-7839"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "262 CHAPMAN RD STE 203",
            "city": "NEWARK",
            "state": "DE",
            "postal_code": "197025442",
            "telephone_number": "302-689-3562",
            "fax_number": "302-294-1757"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRATHWAITE",
        "first_name": "RENE",
        "middle_name": "GREGSTON",
        "name_prefix": "Mr.",
        "credential": "LPCMH, ICCDP-D, NCC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-08-02",
        "last_updated": "2024-01-09",
        "certification_date": "2024-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "DE",
            "license": "PC-0000813",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newark, DE

Sources for this page

Verify at the official NPI Registry.