| Mr Brian Keith Wall, LPC | |
|
3019 Falstaff Rd, Raleigh, NC 27610-1812 | |
| (919) 250-7000 | |
| (919) 231-3231 |
| Full Name | Mr Brian Keith Wall |
|---|---|
| Gender | Male |
| Speciality | Mental Health Counselor |
| Experience | 22 Years |
| Location | 3019 Falstaff Rd, Raleigh, North Carolina |
| Accepts Medicare Assignments | May be. He may accept the Medicare-approved amount; you may be billed for more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1184941940 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | 7369 (North Carolina) | Secondary |
| 101YP2500X | Counselor - Professional | 8524 (South Carolina) | Primary |
| Entity Name | Sondermind Provider Network LLC |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1760854442 PECOS PAC ID: 9537572490 Enrollment ID: O20240620000157 |
| Mailing Address | Practice Location Address |
|---|---|
| Mr Brian Keith Wall, LPC 1213 Chimney Hill Dr, Apex, NC 27502-6416 Ph: (919) 896-4430 | Mr Brian Keith Wall, LPC 3019 Falstaff Rd, Raleigh, NC 27610-1812 Ph: (919) 250-7000 |
Mrs. Mary Muthoni Barine, LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 4700 Falls Of Neuse Rd Ste 355, Raleigh, NC 27609 Phone: 855-501-1004 |
Mr. Duncan Njaramba Kihoro, MA, LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 8211 Willowglen Dr, Raleigh, NC 27616 Phone: 919-266-7784 |
Katherine Ann Good, LCMHC Counselor Medicare: Not Enrolled in Medicare Practice Location: 230 W Millbrook Rd, Raleigh, NC 27609 Phone: 540-998-9704 |
Susan L Dowd, MSW, LCAS Counselor Medicare: Not Enrolled in Medicare Practice Location: 4021 Bella Park Trl Apt 418, Raleigh, NC 27613 Phone: 919-798-3419 |
James Treires, LPCA Counselor Medicare: Not Enrolled in Medicare Practice Location: 5509 Creedmoor Rd, Raleigh, NC 27612 Phone: 919-573-6520 Fax: 919-573-6555 |
Kimberly Hope Brandon, Counselor Medicare: Not Enrolled in Medicare Practice Location: 6516 Falls Of Neuse Rd Ste 110, Raleigh, NC 27615 Phone: 919-423-2310 |
Mr. Gabriel Rosenboro, BS CRIMINAL JUSTICE Counselor Medicare: Not Enrolled in Medicare Practice Location: 4400 Old Poole Rd, Raleigh, NC 27610 Phone: 919-268-9660 |