Theresa Shea Rouse, LCSW-A

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

P017800 Issued in NC

Practice address

1480 Chapel Ridge Rd Ste 220
Apex, NC 27502-8504

Phone

(919) 355-9792

NPI assigned

Jul 21, 2022

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Brinkley Brown Mental Wellness PLLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Apex, NC
  • NPI 1821697293

  Clinical

  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1658361600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1366177461",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1480 CHAPEL RIDGE RD STE 220",
            "city": "APEX",
            "state": "NC",
            "postal_code": "275028504",
            "telephone_number": "919-355-9792"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1480 CHAPEL RIDGE RD STE 220",
            "city": "APEX",
            "state": "NC",
            "postal_code": "275028504",
            "telephone_number": "919-355-9792"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROUSE",
        "first_name": "THERESA",
        "middle_name": "SHEA",
        "credential": "LCSW-A",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-07-21",
        "last_updated": "2022-07-21",
        "certification_date": "2022-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "P017800",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "http://www.brinkleybrownmentalwellness.com/",
            "affiliation": "N",
            "address_1": "1480 Chapel Ridge Rd Ste 220",
            "city": "Apex",
            "state": "NC",
            "country_code": "US",
            "postal_code": "275028504",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Elizabeth Jane Romero, M.S., CCC-SLP
• Ronald Venezie, DDS, Ms, PA
• Lindsey Marie Rose, MD
• Tameka M Roundtree
• Anneka Yvette Rountree
• Paramita Roy, DDS
• Melissa Rudock, PT
• Holly Russell, LMFT
• Samantha Ryan, OTR
• Heesook Ryu

• Clinical Social Worker in Apex, NC
• Providers in Apex, NC by specialty
• Clinical Social Worker in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.