Active NPI
Brandon Patrick Riddick, LCMHC, NCC
- Mental Health Counselor
- Elizabeth City, NC
National Provider Identifier
1962266676
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 19701
- Practice address
- 407 S Griffin St Ste J
Elizabeth City, NC 27909-4693 - Phone
- (252) 331-0322
- Fax
- (252) 331-0320
- NPI assigned
- Feb 13, 2024
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 19701 | NC | Primary |
Addresses
Primary practice location
407 S Griffin St Ste J
Elizabeth City, NC 27909-4693
Mailing address
407 S Griffin St Ste J
Elizabeth City, NC 27909-4693
Phone (252) 331-0322
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Mental Health Counselor
- Education
- Other, 2023
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
407 S Griffin St
Suite J
Elizabeth City, NC 27909-4693
Phone (252) 331-0322
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 19701 | NC | MD | Mental Health Counselor |
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.
-
- Community/Behavioral Health Agency
- Greenville, NC
- NPI 1760420186
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1707782400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1773273600000",
"number": "1962266676",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "407 S GRIFFIN ST STE J",
"city": "ELIZABETH CITY",
"state": "NC",
"postal_code": "279094693",
"telephone_number": "252-331-0322",
"fax_number": "252-331-0320"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "407 S GRIFFIN ST STE J",
"city": "ELIZABETH CITY",
"state": "NC",
"postal_code": "279094693",
"telephone_number": "252-331-0322",
"fax_number": "252-331-0320"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RIDDICK",
"first_name": "BRANDON",
"middle_name": "PATRICK",
"credential": "LCMHC, NCC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2024-02-13",
"last_updated": "2026-03-12",
"certification_date": "2026-03-12",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "NC",
"license": "19701",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Elizabeth City, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.