Individual provider Active NPI

Rebecca Royston, LCSW

  • Clinical Social Worker
  • Charlotte, NC
National Provider Identifier
1902972391
Registry record updated Sep 13, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
C009275 Issued in NC
Practice address
4108 Park Rd Ste 101
Charlotte, NC 28209-4207
Phone
(704) 326-2252
NPI assigned
Nov 28, 2006
Last updated
Sep 13, 2020By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 13, 2020

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 C009275 NC Primary

Addresses

Primary practice location

4108 Park Rd Ste 101
Charlotte, NC 28209-4207

Mailing address

4108 Park Rd Ste 101
Charlotte, NC 28209-4207

Other practice location 1

1808 S Pennsylvania Ave
Suite C
Lansing, MI 48910-1897
Phone (517) 367-0670

Other practice location 2

1212 Mann Dr Ste 100
Matthews, NC 28105-5511
Phone (704) 326-2252

Other practice location 3

18121 W Catawba Ave
Cornelius, NC 28031-5641
Phone (704) 326-2252

Other names 1

  • Rebecca Lynn Bryner 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)
Enrolled

State licenses

LicenseStateTypeSpecialty
C009275NCMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Reflections Wellness Counseling, PLLC Clinical CurrentSince Sep 6, 2020 Accepting new patients
Lindsey Morgan PLLC Past Accepting new patients
DBT Institute of Mi Clinical PastSince Oct 5, 2016 Accepting new patients

Locations

4108 Park Rd
Ste 101
Charlotte, NC 28209
Phone (704) 326-2252

18121 W Catawba Ave
Cornelius, NC 28031
Phone (704) 237-0475

1212 Mann Dr
Ste 100
Matthews, NC 28105
Phone (704) 326-2252

Organizations & group practices 3

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": "1164672000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1599955200000",
    "number": "1902972391",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4108 PARK RD STE 101",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282094207"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4108 PARK RD STE 101",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282094207",
            "telephone_number": "704-326-2252"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1808 S Pennsylvania Ave",
            "address_2": "Suite C",
            "address_purpose": "LOCATION",
            "city": "Lansing",
            "state": "MI",
            "postal_code": "489101897",
            "country_code": "US",
            "telephone_number": "517-367-0670",
            "fax_number": "517-367-0681",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1212 Mann Dr Ste 100",
            "address_purpose": "LOCATION",
            "city": "Matthews",
            "state": "NC",
            "postal_code": "281055511",
            "country_code": "US",
            "telephone_number": "704-326-2252",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "18121 W Catawba Ave",
            "address_purpose": "LOCATION",
            "city": "Cornelius",
            "state": "NC",
            "postal_code": "280315641",
            "country_code": "US",
            "telephone_number": "704-326-2252",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROYSTON",
        "first_name": "REBECCA",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-28",
        "last_updated": "2020-09-13",
        "certification_date": "2020-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "C009275",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "REBECCA",
            "last_name": "BRYNER",
            "middle_name": "LYNN",
            "credential": "LLMSW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Charlotte, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2020; 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.