Brienna Lyn Thompson, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

C015870 Issued in NC

Practice address

1703 Country Club Rd Ste 204
Jacksonville, NC 28546-6098

Phone

(619) 368-1774

NPI assigned

Oct 5, 2010

Last updated

Oct 17, 2023By the provider in NPPES

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

Other names 1

• Brienna Lyn Wilson Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Warrior Wellness

  • Community/Behavioral Health Agency
  • Jacksonville, NC
  • NPI 1548011042
  NPD Authorized official
• Resolutions Counseling and Mediation Services, PLLC

  • Clinical Social Worker
  • Jacksonville, NC
  • NPI 1982868501
  NPD (past)

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

{
    "created_epoch": "1286236800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697500800000",
    "number": "1417266743",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "147 WESTE AVE",
            "city": "JACKSONVILLE",
            "state": "NC",
            "postal_code": "285405805",
            "telephone_number": "619-368-1774"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1703 COUNTRY CLUB RD STE 204",
            "city": "JACKSONVILLE",
            "state": "NC",
            "postal_code": "285466098",
            "telephone_number": "619-368-1774"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMPSON",
        "first_name": "BRIENNA",
        "middle_name": "LYN",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-10-05",
        "last_updated": "2023-10-17",
        "certification_date": "2023-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "C015870",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BRIENNA",
            "last_name": "WILSON",
            "middle_name": "LYN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Thomas E & Kimberly M Morgan DDS PA
• Thomas J Rojy Jr MD PA
• Koithara Varkey Thomas, M.D.
• Madeleine Thomas, DPT, PT
• Mary Parker Thomas
• Carrie Anne Thompson, RBT
• Ellen Thompson
• Jacqueline Brooke Thompson, FNP-C
• Kassandra Joanne Thompson
• Katherine Thompson

• Clinical Social Worker in Jacksonville, NC
• Providers in Jacksonville, 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 Oct 17, 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.

Verify at the official NPI Registry.