Active NPI
Lance Bradley Oldham, LPC
- Professional Counselor
- Greensboro, NC
National Provider Identifier
1013173830
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 7068
- Practice address
- 3707 W Market St Ste D
Greensboro, NC 27403-1399 - Phone
- (336) 209-5315
- Fax
- (336) 665-6188
- NPI assigned
- Jul 31, 2008
- Last updated
- Jul 31, 2008
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 7068 | NC | Primary |
Addresses
Primary practice location
3707 W Market St Ste D
Greensboro, NC 27403-1399
Mailing address
3707 W Market St Ste D
Greensboro, NC 27403-1399
Phone (336) 209-5315
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NC
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Mental Health Counselor
- Education
- Other, 2006
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
66 E Flagler St
Miami, FL 33130-1807
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 7068 | NC | MD | Pediatric Dentist |
Networks
- TN PPO C-SNP
- TN PPO
- devoted network organization-92131eb0-09f2-4173-a140-cf7b381f0cf1
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1217462400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1217462400000",
"number": "1013173830",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3707 W MARKET ST STE D",
"city": "GREENSBORO",
"state": "NC",
"postal_code": "274031399",
"telephone_number": "336-209-5315",
"fax_number": "336-665-6188"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3707 W MARKET ST STE D",
"city": "GREENSBORO",
"state": "NC",
"postal_code": "274031399",
"telephone_number": "336-209-5315",
"fax_number": "336-665-6188"
}
],
"practiceLocations": [],
"basic": {
"last_name": "OLDHAM",
"first_name": "LANCE",
"middle_name": "BRADLEY",
"credential": "LPC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2008-07-31",
"last_updated": "2008-07-31",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "NC",
"license": "7068",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Greensboro, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.