Individual provider Active NPI

Julius Albert Suttle III, LPC

  • Professional Counselor
  • Arden, NC
National Provider Identifier
1104021393
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
2227 Issued in NC
Practice address
39 Fieldcrest Rd
Arden, NC 28704-9423
Phone
(828) 778-0343
Fax
(828) 684-0772
NPI assigned
Jun 18, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 2227 NC Primary

Addresses

Primary practice location

39 Fieldcrest Rd
Arden, NC 28704-9423

Mailing address

39 Fieldcrest Rd
Arden, NC 28704-9423
Phone (828) 778-0343

Other identifiers 1

IdentifierTypeStateIssuer
6102938MedicaidNC

Other names 1

  • Mr. Julius Bert Suttle Other name

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
2227NCMDAthletic Trainer

NPI Registry JSON

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

{
    "created_epoch": "1182124800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1104021393",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "39 FIELDCREST RD",
            "city": "ARDEN",
            "state": "NC",
            "postal_code": "287049423",
            "telephone_number": "828-778-0343",
            "fax_number": "828-684-0772"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "39 FIELDCREST RD",
            "city": "ARDEN",
            "state": "NC",
            "postal_code": "287049423",
            "telephone_number": "828-778-0343",
            "fax_number": "828-684-0772"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUTTLE III",
        "first_name": "JULIUS",
        "middle_name": "ALBERT",
        "name_prefix": "Mr.",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-06-18",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NC",
            "license": "2227",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6102938",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JULIUS",
            "last_name": "SUTTLE",
            "middle_name": "BERT",
            "prefix": "MR.",
            "credential": "LPC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Arden, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.