Individual provider Active NPI

Janae Poole, LMFTA

  • Marriage & Family Therapist
  • Raleigh, NC
National Provider Identifier
1003402769
Registry record updated Dec 16, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
12253A Issued in NC
Practice address
9121 Anson Way Ste 200
Raleigh, NC 27615-5857
Phone
(984) 204-1337
NPI assigned
Dec 16, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 16, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 12253A NC Primary

Addresses

Primary practice location

9121 Anson Way Ste 200
Raleigh, NC 27615-5857

Mailing address

5109 Timmons Dr
Durham, NC 27713-2355
Phone (919) 638-0631

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL https://secure.simplepractice.com/users/sign_in

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
12253ANCMDMarriage & Family Therapist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1608076800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1608076800000",
    "number": "1003402769",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5109 TIMMONS DR",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277132355",
            "telephone_number": "919-638-0631"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9121 ANSON WAY STE 200",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276155857",
            "telephone_number": "984-204-1337"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POOLE",
        "first_name": "JANAE",
        "name_prefix": "Mrs.",
        "credential": "LMFTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-12-16",
        "last_updated": "2020-12-16",
        "certification_date": "2020-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "NC",
            "license": "12253A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "https://secure.simplepractice.com/users/sign_in",
            "affiliation": "N",
            "address_1": "9121 Anson Way Ste 200",
            "city": "Raleigh",
            "state": "NC",
            "country_code": "US",
            "postal_code": "276155857",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Raleigh, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.