Boys and Girls Clubs of Central Carolina

Primary specialty

CounselorTaxonomy code 101Y00000X

Legal business name

BOYS AND GIRLS CLUBS OF CENTRAL CAROLINA

Practice address

1414 Bragg St
Sanford, NC 27330-5435

Phone

(919) 825-0101

NPI assigned

Nov 5, 2025

Last updated

Nov 5, 2025By the provider in NPPES

Organization subpart

Yes

Parent organization

O. T. SLOAN BOYS AND GIRLS CLUBAs reported in NPPES

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

Authorized official

Name

Dr. Fallon Brewington, ED.D, CPTD

Title

Chief Executive Officer

Phone

(919) 825-0101

Specialties & licenses 1

Addresses

Part of

Boys and Girls Clubs of Central Carolina

Locations

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

{
    "created_epoch": "1762300800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1762300800000",
    "number": "1669341772",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1414 BRAGG ST",
            "city": "SANFORD",
            "state": "NC",
            "postal_code": "273305435",
            "telephone_number": "919-825-0101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1414 BRAGG ST",
            "city": "SANFORD",
            "state": "NC",
            "postal_code": "273305435",
            "telephone_number": "919-825-0101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BOYS AND GIRLS CLUBS OF CENTRAL CAROLINA",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "O. T. SLOAN BOYS AND GIRLS CLUB",
        "enumeration_date": "2025-11-05",
        "last_updated": "2025-11-05",
        "certification_date": "2025-11-05",
        "status": "A",
        "authorized_official_last_name": "BREWINGTON",
        "authorized_official_first_name": "FALLON",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "919-825-0101",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "ED.D, CPTD"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ashley G. Boles
• Samantha E Borden, PNP
• Brandi B Bossinger, PT
• Jill Christine Botnick
• Mackenzie Boyd
• Brianna Nyshee Brackeen
• Stacy Sharpe Brafford, OTR
• Sara Lynn Branch, PA
• Kendra Nicole Brandt, PA-C
• Breakthrough Physical Therapy Inc

• Counselor in Sanford, NC
• Providers in Sanford, NC by specialty
• Counselor in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2025; 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.