Active NPI
Brian K Ervin
- Professional Counselor
- Brandon, MS
National Provider Identifier
1578707212
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 1946
- Practice address
- 430 Bay Pointe Cir
Brandon, MS 39047-8553 - Phone
- (601) 454-4379
- Fax
- (601) 829-9383
- NPI assigned
- Apr 24, 2009
- Last updated
- Oct 13, 2014
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 1946 | MS | Primary |
| Marriage & Family Therapist | 106H00000X | T0280 | MS |
Addresses
Primary practice location
430 Bay Pointe Cir
Brandon, MS 39047-8553
Mailing address
1700 W Government St
Suite C
Brandon, MS 39042-2417
Phone (601) 454-4379
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 |
|---|---|---|---|
| 1946 | MS | MD | Professional Counselor |
| T0280 | MS | MD | Marriage & Family Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1240531200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1413158400000",
"number": "1578707212",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1700 W GOVERNMENT ST",
"address_2": "SUITE C",
"city": "BRANDON",
"state": "MS",
"postal_code": "390422417",
"telephone_number": "601-454-4379",
"fax_number": "601-829-9383"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "430 BAY POINTE CIR",
"city": "BRANDON",
"state": "MS",
"postal_code": "390478553",
"telephone_number": "601-454-4379",
"fax_number": "601-829-9383"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ERVIN",
"first_name": "BRIAN",
"middle_name": "K",
"name_prefix": "Mr.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2009-04-24",
"last_updated": "2014-10-13",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "MS",
"license": "1946",
"primary": true
},
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "MS",
"license": "T0280",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Brandon, MS
- Encounter Community Counseling Center, LLC
- Enduracare Acute Care Services LLC (Enduracare Acute Care Services Brandon)
- Erica Sutton,RN
- Kayla Anthony Erickson, LPC
- Erin Green DDS PC (Grants Ferry Family Dentistry)
- Baron C Evans
- Picton Timothy Evans, PHARMD
- Excel Physical Therapy and Wellness Center, PLLC
- Mary E Fair
- Family Health Care Clinic, Inc
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.