Individual provider Active NPI

Caroline Gray Brinson

  • Mental Health Counselor
  • Wilmington, NC
National Provider Identifier
1700679586
Registry record updated May 26, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
A21411 Issued in NC
Practice address
890 S Kerr Ave Ste 200
Wilmington, NC 28403-4248
Phone
(910) 599-8653
NPI assigned
May 26, 2025
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 26, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X A21411 NC Primary

Addresses

Primary practice location

890 S Kerr Ave Ste 200
Wilmington, NC 28403-4248

Mailing address

4429 Old Towne St
Wilmington, NC 28412-5009
Phone (910) 599-8653

Other names 1

  • Miss Caroline Gray Rivenbark Former name

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
A21411NCMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1748217600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1748217600000",
    "number": "1700679586",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4429 OLD TOWNE ST",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284125009",
            "telephone_number": "910-599-8653",
            "fax_number": "910-599-8653"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "890 S KERR AVE STE 200",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284034248",
            "telephone_number": "910-599-8653"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRINSON",
        "first_name": "CAROLINE",
        "middle_name": "GRAY",
        "name_prefix": "Mrs.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-05-26",
        "last_updated": "2025-05-26",
        "certification_date": "2025-05-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NC",
            "license": "A21411",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CAROLINE",
            "last_name": "RIVENBARK",
            "middle_name": "GRAY",
            "prefix": "MISS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Wilmington, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 26, 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.