Provider Demographics
NPI:1821697293
Name:BRINKLEY BROWN MENTAL WELLNESS PLLC
Entity Type:Organization
Organization Name:BRINKLEY BROWN MENTAL WELLNESS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:LIANA
Authorized Official - Middle Name:
Authorized Official - Last Name:DIBERTO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:919-656-2437
Mailing Address - Street 1:1480 CHAPEL RIDGE RD STE 220
Mailing Address - Street 2:
Mailing Address - City:APEX
Mailing Address - State:NC
Mailing Address - Zip Code:27502-8504
Mailing Address - Country:US
Mailing Address - Phone:919-355-9792
Mailing Address - Fax:919-551-7518
Practice Address - Street 1:1480 CHAPEL RIDGE RD STE 220
Practice Address - Street 2:
Practice Address - City:APEX
Practice Address - State:NC
Practice Address - Zip Code:27502-8504
Practice Address - Country:US
Practice Address - Phone:919-355-9792
Practice Address - Fax:919-551-7518
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-18
Last Update Date:2022-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty