Active NPI
Jenna Lane
- Professional Counselor
- Matthews, NC
National Provider Identifier
1023725819
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- A17813
- Practice address
- 9719 Northeast Pkwy
Matthews, NC 28105-9712 - Phone
- (704) 443-8148
- NPI assigned
- Nov 1, 2022
- Sex
- Female
- 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 | A17813 | NC | Primary |
Addresses
Primary practice location
9719 Northeast Pkwy
Matthews, NC 28105-9712
Mailing address
13209 Indian Hills LN
Charlotte, NC 28278-7140
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
| License | State | Type | Specialty |
|---|---|---|---|
| A17813 | NC | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1667260800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1667260800000",
"number": "1023725819",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "13209 INDIAN HILLS LN",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282787140"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9719 NORTHEAST PKWY",
"city": "MATTHEWS",
"state": "NC",
"postal_code": "281059712",
"telephone_number": "704-443-8148"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LANE",
"first_name": "JENNA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2022-11-01",
"last_updated": "2022-11-01",
"certification_date": "2022-11-01",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "NC",
"license": "A17813",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Matthews, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.