Individual provider Active NPI

Richard Fairlie Brinkley, LCSW, CAP, NCGC II

  • Clinical Social Worker
  • Largo, FL
National Provider Identifier
1811193782
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
SW6527 Issued in FL
Practice address
1101 Belcher Rd S Ste E
Largo, FL 33771-3356
Phone
(727) 512-3264
Fax
(727) 536-8040
NPI assigned
Jun 26, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X SW6527 FL Primary

Addresses

Primary practice location

1101 Belcher Rd S Ste E
Largo, FL 33771-3356

Mailing address

13761 Forest Lake Dr
Largo, FL 33771-5018
Phone (727) 512-3264

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
SW6527FLMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1182816000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1811193782",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13761 FOREST LAKE DR",
            "city": "LARGO",
            "state": "FL",
            "postal_code": "337715018",
            "telephone_number": "727-512-3264",
            "fax_number": "727-536-8040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1101 BELCHER RD S STE E",
            "city": "LARGO",
            "state": "FL",
            "postal_code": "337713356",
            "telephone_number": "727-512-3264",
            "fax_number": "727-536-8040"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRINKLEY",
        "first_name": "RICHARD",
        "middle_name": "FAIRLIE",
        "name_prefix": "Mr.",
        "credential": "LCSW, CAP, NCGC II",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-06-26",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW6527",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Largo, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.