Active NPI
Julianne T. Gold Brunson, PH.D.., HSP-P
- Clinical Psychologist
- Charlotte, NC
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 102909
- Practice address
- 4108 Park Road
Charlotte, NC 28209-2563 - Phone
- (704) 469-5982
- Fax
- (704) 522-5484
- NPI assigned
- Sep 1, 2010
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 102909 | NC | Primary |
Addresses
Primary practice location
4108 Park Road
Charlotte, NC 28209-2563
Mailing address
4108 Park Road
Charlotte, NC 28209-2563
Phone (704) 469-5982
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NC
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Psychologist
- Education
- Other, 2009
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
4108 Park Rd
Suite 307
Charlotte, NC 28209-2261
Phone (704) 522-5424
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4256 | NC | MD | Professional Counselor |
| 102909 | NC | MD | Clinical Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Rha Health Services, Inc | Current | Accepting new patients | |
| Rha Health Services, Inc. | Current | Accepting new patients | |
| Rha Health Services Inc | Current | Accepting new patients | |
| Journey, Inc. | Past | Accepting new patients |
Locations
211 Perimeter Center Pkwy NE
Ste 750
Atlanta, GA 30346
1819 Peachtree Rd NE
Ste 450
Atlanta, GA 30309
Phone (910) 332-5734
4108 Park Rd
Ste 307
Charlotte, NC 28209
Phone (704) 336-6570
211 S Centennial St
High Point, NC 27260
Phone (336) 841-0143
Organizations & group practices 4
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.
-
- Community/Behavioral Health Agency
- Concord, NC
- NPI 1447376306
-
- Community/Behavioral Health Agency
- Yanceyville, NC
- NPI 1629489307
-
- Community/Behavioral Health Agency
- Charlotte, NC
- NPI 1326341819
-
- Community/Behavioral Health Agency
- Charlotte, NC
- NPI 1255521464
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1283299200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1349740800000",
"number": "1487961124",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4108 PARK ROAD",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282092563",
"telephone_number": "704-469-5982",
"fax_number": "704-522-5484"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4108 PARK ROAD",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282092563",
"telephone_number": "704-469-5982",
"fax_number": "704-522-5484"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GOLD BRUNSON",
"first_name": "JULIANNE",
"middle_name": "T.",
"name_prefix": "Dr.",
"credential": "PH.D.., HSP-P",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-09-01",
"last_updated": "2012-10-09",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "NC",
"license": "102909",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Charlotte, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.