Individual provider Active NPI

Erica Ashley Brumfield, LPC

  • Professional Counselor
  • Brandon, MS
National Provider Identifier
1457804148
Registry record updated Sep 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
1843 Issued in MS
Practice address
501 Avalon Way Ste D
Brandon, MS 39047-7500
Phone
(601) 874-3340
Fax
(601) 494-3241
NPI assigned
Jul 28, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 30, 2024

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X 1843 MS
Counselor 101Y00000X 9780 LA
Professional Counselor 101YP2500X 9780 LA
Professional Counselor 101YP2500X 1843 MS Primary

Addresses

Primary practice location

501 Avalon Way Ste D
Brandon, MS 39047-7500

Mailing address

PO Box 68375
Jackson, MS 39286-8375
Phone (601) 874-3340

Other identifiers 1

IdentifierTypeStateIssuer
009356703MedicaidMS

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

LicenseStateTypeSpecialty
1843MSMDCounselor
9780LAMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Ebullience Counseling Counselor CurrentSince Oct 6, 2024 Accepting new patients

Locations

501 Avalon Way
Ste D
Brandon, MS 39047

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1469664000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727654400000",
    "number": "1457804148",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 68375",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392868375",
            "telephone_number": "601-874-3340",
            "fax_number": "601-494-3340"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 AVALON WAY STE D",
            "city": "BRANDON",
            "state": "MS",
            "postal_code": "390477500",
            "telephone_number": "601-874-3340",
            "fax_number": "601-494-3241"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRUMFIELD",
        "first_name": "ERICA",
        "middle_name": "ASHLEY",
        "name_prefix": "Miss",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-07-28",
        "last_updated": "2024-09-30",
        "certification_date": "2024-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "MS",
            "license": "1843",
            "primary": false
        },
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "LA",
            "license": "9780",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "LA",
            "license": "9780",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MS",
            "license": "1843",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "009356703",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brandon, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2024; 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.