Active NPI
Jessica Wood
- Mental Health Counselor
- Charlotte, NC
National Provider Identifier
1033592282
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- P009470
- Practice address
- 8801 J M Keynes Dr Ste 440
Charlotte, NC 28262-5483 - Phone
- (704) 537-9551
- NPI assigned
- Jul 7, 2015
- Last updated
- Jul 7, 2015
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | P009470 | NC | Primary |
Addresses
Primary practice location
8801 J M Keynes Dr Ste 440
Charlotte, NC 28262-5483
Mailing address
4914 Kistler Ave
Charlotte, NC 28205-7326
Phone (740) 821-1442
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 |
|---|---|---|---|
| P009470 | NC | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1436227200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1436227200000",
"number": "1033592282",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4914 KISTLER AVE",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282057326",
"telephone_number": "740-821-1442"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8801 J M KEYNES DR STE 440",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282625483",
"telephone_number": "704-537-9551"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WOOD",
"first_name": "JESSICA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-07-07",
"last_updated": "2015-07-07",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "NC",
"license": "P009470",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Charlotte, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.