Individual provider Active NPI

Cristina Bruington, LMFT, LCAS, CCS

  • Marriage & Family Therapist
  • Huntersville, NC
National Provider Identifier
1902212137
Registry record updated Feb 20, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
1958 Issued in NC
Practice address
10224 Hickorywood Hill Ave Ste 205
Huntersville, NC 28078-3474
Phone
(704) 999-0505
NPI assigned
Jul 9, 2014
Last updated
Feb 20, 2020By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 20, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 22663 NC
Marriage & Family Therapist 106H00000X 1958 NC Primary

Addresses

Primary practice location

10224 Hickorywood Hill Ave Ste 205
Huntersville, NC 28078-3474

Mailing address

10224 Hickorywood Hill Ave Ste 205
Huntersville, NC 28078-3474
Phone (704) 999-0505

Other identifiers 1

IdentifierTypeStateIssuer
19M5UOtherNCBLUE CROSS BLUE SHIELD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241121004524 NC Practitioner - Marriage and Family Therapist 4688109093 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
22663NCMDAddiction (Substance Use Disorder) Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Telos Health Systems NC PLLC CurrentSince Aug 5, 2024 Accepting new patients

Locations

550 Glenwood Dr
Mooresville, NC 28115
Phone (704) 644-4797

1000 College St
Wilkesboro, NC 28697
Phone (336) 838-4141

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1404864000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1582156800000",
    "number": "1902212137",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10224 HICKORYWOOD HILL AVE STE 205",
            "city": "HUNTERSVILLE",
            "state": "NC",
            "postal_code": "280783474",
            "telephone_number": "704-999-0505"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10224 HICKORYWOOD HILL AVE STE 205",
            "city": "HUNTERSVILLE",
            "state": "NC",
            "postal_code": "280783474",
            "telephone_number": "704-999-0505"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRUINGTON",
        "first_name": "CRISTINA",
        "credential": "LMFT, LCAS, CCS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-07-09",
        "last_updated": "2020-02-20",
        "certification_date": "2020-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NC",
            "license": "22663",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "NC",
            "license": "1958",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "19M5U",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Huntersville, NC

Sources for this page

Verify at the official NPI Registry.