MR. BRIAN KEITH WALL LPC
NPI 1184941940
Counselor - Professional in Raleigh, NC

Q: What is Brian Wall's NPI number?

The NPI number for Brian Wall is 1184941940. It was assigned to this individual provider in the NPPES registry on May 3, 2010.

Q: What is Brian Wall's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Professional, with taxonomy code 101YP2500X.

Q: When was this NPI record last updated?

The NPPES record for Brian Wall was last updated on September 8, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since May 03, 2010PECOS Enrolled

3019 FALSTAFF RD, RALEIGH, NC 27610(919) 250-7000(919) 231-3231 Get Directions Write a Review

NPPES record last updated: September 8, 2023. Verified against the NPPES registry weekly; last sync: October 18, 2026.

On this page

About Mr. Brian Keith Wall Lpc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MR. BRIAN KEITH WALL LPC (NPI 1184941940) is an individual professional provider in Raleigh, North Carolina, licensed in South Carolina (8524) and active in the NPI registry since May 2010. He is enrolled in Medicare PECOS, maintains a secondary practice location in Greenville, and is a graduate of Other (2004).

NPPES Registry Identity

NPI1184941940

Entity TypeIndividualMale

Primary Taxonomy101YP2500X

Provider Legal NameMR. BRIAN KEITH WALLCredential: LPC

Location Address3019 FALSTAFF RDRaleigh, NC 27610-1812

Mailing Address1213 Chimney Hill DrApex, NC 27502-6416 · (919) 896-4430 · Fax (919) 000-0000

Phone(919) 250-7000

Fax(919) 231-3231

Sole ProprietorNo

Medical School CMSOtherGraduated 2004

Enumeration DateMay 3, 2010

Last NPPES UpdateSeptember 8, 2023

NPPES CertifiedSeptember 8, 2023

✔ NPI 1184941940 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · ProfessionalBehavioral Health & Social Service Providers

Taxonomy Code101YP2500X

Licenses✔ Licensed in SC · 8524✔ Licensed in NC · 7369

3019 FALSTAFF RD, Raleigh, NC 27610

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Secondary Practice Location 1

Location 168 Pointe Cir Ste 3201Greenville, SC 29615-6307 · Phone (855) 284-7483

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Oscar Health Maintenance Organization of Florida, UnitedHealthcare.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Mr. Brian Keith Wall Lpc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID3971955949

PECOS Enrollment IDI20260114000070

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Brian Wall reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Sondermind Provider Network LLC

1,466 mi

Clinical

1738 WYNKOOP ST STE 303
Denver, CO 80202

Reassigned Medicare billing, Florida and South Carolina enrollments
238 clinicians in this Medicare group

NPI 1760854442 (844) 843-7279

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

JENNIFER METZGER LCSW

Social Worker (Clinical)