Individual provider Active NPI

Janice Pepper O'Bryant, M.S,. LPA, LPC

  • Mental Health Counselor
  • Wilmington, NC
National Provider Identifier
1508985482
Registry record updated Oct 18, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
2945 Issued in NC
Practice address
5710 Oleander Dr Ste 112
Wilmington, NC 28403-4722
Phone
(910) 769-1785
NPI assigned
Mar 29, 2007
Last updated
Oct 18, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 18, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X 2945 NC
Mental Health Counselor 101YM0800X 2945 NC Primary

Addresses

Primary practice location

5710 Oleander Dr Ste 112
Wilmington, NC 28403-4722

Mailing address

1302 Old Lamplighter Way
Wilmington, NC 28403-3430
Phone (910) 313-1776

Other practice location 1

1606 Wellington Ave Unit C
Community Support Professionals,LLC
Wilmington, NC 28401-7704
Phone (910) 799-4505 ext. 228

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240207001350 NC Practitioner - Mental Health Counselor 6103180070 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 1983
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pride in North Carolina LLCGroup PAC ID 9638105869, 34 clinicians

Practice addresses (Care Compare)

5710 Oleander Dr
Suite 112
Wilmington, NC 28403-4722
Phone (910) 769-1785

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
2945NCMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Pride in North Carolina, LLC Mental Health CurrentSince Jan 26, 2024 Accepting new patients
Pride in North Carolina, LLC Mental Health CurrentSince Jan 26, 2024 Accepting new patients

Locations

231 Commerce St
Greenville, NC 27858
Phone (252) 321-8080

2902 N Herritage St
#A
Kinston, NC 28501
Phone (252) 520-6740

5710 Oleander Dr
Ste 112
Wilmington, NC 28403
Phone (910) 769-1785

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1175126400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666051200000",
    "number": "1508985482",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1302 OLD LAMPLIGHTER WAY",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284033430",
            "telephone_number": "910-313-1776"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5710 OLEANDER DR STE 112",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284034722",
            "telephone_number": "910-769-1785"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1606 Wellington Ave Unit C",
            "address_2": "Community Support Professionals,LLC",
            "address_purpose": "LOCATION",
            "city": "Wilmington",
            "state": "NC",
            "postal_code": "284017704",
            "country_code": "US",
            "telephone_number": "910-799-4505 x228",
            "fax_number": "910-799-4345",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "O'BRYANT",
        "first_name": "JANICE",
        "middle_name": "PEPPER",
        "name_prefix": "Mrs.",
        "credential": "M.S,. LPA, LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-29",
        "last_updated": "2022-10-18",
        "certification_date": "2022-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "NC",
            "license": "2945",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NC",
            "license": "2945",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wilmington, NC

Sources for this page

Verify at the official NPI Registry.