Individual provider Active NPI

Carrie Bravinder, LPC

  • Professional Counselor
  • Stafford, VA
National Provider Identifier
1629162755
Registry record updated Jun 1, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
0701011497 Issued in VA
Practice address
12 Flatford Rd
Stafford, VA 22554-3949
Phone
(800) 305-2089
NPI assigned
Oct 3, 2006
Last updated
Jun 1, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 1, 2022

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

Specialties & licenses 7

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X LPC 00162 MN
Mental Health Counselor 101YM0800X 14768 NC
Professional Counselor 101YP2500X MH 10728 FL
Professional Counselor 101YP2500X 4789 OK
Professional Counselor 101YP2500X 74487 TX
Professional Counselor 101YP2500X 0184121 NM
Professional Counselor 101YP2500X 0701011497 VA Primary

Addresses

Primary practice location

12 Flatford Rd
Stafford, VA 22554-3949

Mailing address

24 White Chapel LN
Stafford, VA 22554-8593
Phone (321) 795-8596

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
LPC 00162MNMDMental Health Counselor
MH 10728FLMDProfessional Counselor
0184121NMMDProfessional Counselor
0701011497VAMDProfessional Counselor
74487TXMDPharmacist
4789OKMDPediatric Critical Care Medicine Physician
14768NCMDOccupational Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1159833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654041600000",
    "number": "1629162755",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24 WHITE CHAPEL LN",
            "city": "STAFFORD",
            "state": "VA",
            "postal_code": "225548593",
            "telephone_number": "321-795-8596"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12 FLATFORD RD",
            "city": "STAFFORD",
            "state": "VA",
            "postal_code": "225543949",
            "telephone_number": "800-305-2089"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRAVINDER",
        "first_name": "CARRIE",
        "name_prefix": "Ms.",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-03",
        "last_updated": "2022-06-01",
        "certification_date": "2022-06-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MN",
            "license": "LPC 00162",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NC",
            "license": "14768",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "FL",
            "license": "MH 10728",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "OK",
            "license": "4789",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "TX",
            "license": "74487",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NM",
            "license": "0184121",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "VA",
            "license": "0701011497",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stafford, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 2022; 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.