Active NPI
Erica Ashley Brumfield, LPC
- Professional Counselor
- Brandon, MS
National Provider Identifier
1457804148
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 1843
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 009356703 | Medicaid | MS |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 1843 | MS | MD | Counselor |
| 9780 | LA | MD | Professional Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ebullience Counseling | Counselor | Current | 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.
-
- Professional Counselor
- Brandon, MS
- NPI 1326866120
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.