Provider Demographics
NPI:1952395170
Name:BRINICH, PAUL M (PHD)
Entity Type:Individual
Prefix:DR
First Name:PAUL
Middle Name:M
Last Name:BRINICH
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:601 W ROSEMARY ST
Mailing Address - Street 2:UNIT 804
Mailing Address - City:CHAPEL HILL
Mailing Address - State:NC
Mailing Address - Zip Code:27516-2362
Mailing Address - Country:US
Mailing Address - Phone:919-442-8653
Mailing Address - Fax:
Practice Address - Street 1:601 W ROSEMARY ST
Practice Address - Street 2:UNIT 804
Practice Address - City:CHAPEL HILL
Practice Address - State:NC
Practice Address - Zip Code:27516-2362
Practice Address - Country:US
Practice Address - Phone:919-442-8653
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-02
Last Update Date:2015-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1556103TC0700X, 103TC2200X, 103TP0814X, 103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TP0814XBehavioral Health & Social Service ProvidersPsychologistPsychoanalysis
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent
No103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC0331EOtherBLUE CROSS / BLUE SHIELD