NPIMap

Organization Active NPI

Family Ties of Brunswick, LLC

Doing business as Family Ties Mental Health and Substance Abuse Counseling Services

  • Professional Counselor
  • Wilmington, NC
National Provider Identifier
1831682665
Registry record updated Nov 16, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
20956 Issued in NC
Legal business name
FAMILY TIES OF BRUNSWICK, LLC
Doing business as
Family Ties Mental Health and Substance Abuse Counseling Services
Practice address
720 N 3Rd St Ste 401
Wilmington, NC 28401-3474
Phone
(910) 769-9126
Fax
(910) 769-9169
NPI assigned
Jun 6, 2018
Last updated
Nov 16, 2023By the provider in NPPES
Organization subpart
Yes
Parent organization
FAMILY TIES OF BRUNSWICK, LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Nov 16, 2023

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

Authorized official

Name
Ms. Bridget Dixon Milliken, LCMHC, LCASANPI 1265776876
Title
Owner
Phone
(910) 393-8502

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YM0800X 9796 NC
Mental Health CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YM0800X
Professional CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YP2500X 20956 NC Primary
Clinical Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041C0700X

Addresses

Primary practice location

720 N 3Rd St Ste 401
Wilmington, NC 28401-3474

Mailing address

720 N 3Rd St Ste 401
Wilmington, NC 28401-3474
Phone (910) 769-9126

Other practice location 1

5320 Bridgers Rd Ste 4
Shallotte, NC 28470-4737
Phone (910) 754-4097

Other practice location 2

201 N Front St Ste 704
Wilmington, NC 28401-5090
Phone (910) 769-9126

Other identifiers 2

IdentifierTypeStateIssuer
1265776876MedicaidNC
L774MedicaidNC

Other names 1

  • Family Ties Mental Health and Substance Abuse Counseling Services Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210707000615 NC Part B Supplier - Clinic/Group Practice 7911309430 Receives reassigned benefits from 11 practitioners
Practice locations: Shallotte, NC; Wilmington, NC

National Provider Directory

National Provider Directory
Part of
Family Ties of Brunswick LL

Locations

201 Village Rd
Shallotte, NC 28470
Phone (910) 754-4097

5320 Bridgers Rd
Ste 4
Shallotte, NC 28470
Phone (910) 754-4097

201 N Front St
Ste 615
Wilmington, NC 28401
Phone (910) 769-5855

201 N Front St
Ste 704
Wilmington, NC 28401
Phone (910) 769-9126

720 N 3rd St
Ste 401
Wilmington, NC 28401
Phone (910) 769-9126

Practitioners & affiliated clinicians

Practitioners 19

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 19

NPI Registry JSON

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

{
    "created_epoch": "1528243200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1700092800000",
    "number": "1831682665",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "720 N 3RD ST STE 401",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284013474",
            "telephone_number": "910-769-9126",
            "fax_number": "910-769-9169"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "720 N 3RD ST STE 401",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284013474",
            "telephone_number": "910-769-9126",
            "fax_number": "910-769-9169"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5320 Bridgers Rd Ste 4",
            "address_purpose": "LOCATION",
            "city": "Shallotte",
            "state": "NC",
            "postal_code": "284704737",
            "country_code": "US",
            "telephone_number": "910-754-4097",
            "fax_number": "910-769-9169",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "201 N Front St Ste 704",
            "address_purpose": "LOCATION",
            "city": "Wilmington",
            "state": "NC",
            "postal_code": "284015090",
            "country_code": "US",
            "telephone_number": "910-769-9126",
            "fax_number": "910-769-9169",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "FAMILY TIES OF BRUNSWICK, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "FAMILY TIES OF BRUNSWICK, LLC",
        "enumeration_date": "2018-06-06",
        "last_updated": "2023-11-16",
        "certification_date": "2023-11-16",
        "status": "A",
        "authorized_official_last_name": "MILLIKEN",
        "authorized_official_first_name": "BRIDGET",
        "authorized_official_middle_name": "DIXON",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "910-393-8502",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "LCMHC, LCASA"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": "NC",
            "license": "9796",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": "NC",
            "license": "20956",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1265776876",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "L774",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Family Ties Mental Health and Substance Abuse Counseling Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Nov 16, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.