Provider Demographics
NPI:1861913139
Name:CRAIN, BRYONY WILLIAMS (NCC, LPC)
Entity type:Individual
Prefix:MRS
First Name:BRYONY
Middle Name:WILLIAMS
Last Name:CRAIN
Suffix:
Gender:F
Credentials:NCC, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 99446
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27624-9446
Mailing Address - Country:US
Mailing Address - Phone:919-533-2406
Mailing Address - Fax:919-289-1698
Practice Address - Street 1:180 MINE LAKE CT STE 200
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27615-6417
Practice Address - Country:US
Practice Address - Phone:919-533-2406
Practice Address - Fax:919-289-1698
Is Sole Proprietor?:No
Enumeration Date:2017-06-27
Last Update Date:2018-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC7738101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional