Individual provider Active NPI

Jarred Landon Hayes

  • Professional Counselor
  • Charlotte, NC
National Provider Identifier
1154935740
Registry record updated Sep 1, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
A15860 Issued in NC
Practice address
3646 Central Ave
Charlotte, NC 28205-6064
Phone
(704) 733-9934
NPI assigned
Sep 1, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 1, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X A15860 NC Primary
Mental Health Counselor 101YM0800X A15860 NC

Addresses

Primary practice location

3646 Central Ave
Charlotte, NC 28205-6064

Mailing address

PO Box 241981
Charlotte, NC 28224-1981
Phone (980) 500-9342

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
A15860NCMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Project 658 CurrentSince Jul 24, 2022 Accepting new patients
Sage Counseling & Consulting Group PLLC Mental Health CurrentSince Sep 24, 2023 Accepting new patients

Locations

3646 Central Ave
Charlotte, NC 28205
Phone (704) 733-9934

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1598918400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1598918400000",
    "number": "1154935740",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 241981",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282241981",
            "telephone_number": "980-500-9342"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3646 CENTRAL AVE",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282056064",
            "telephone_number": "704-733-9934"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAYES",
        "first_name": "JARRED",
        "middle_name": "LANDON",
        "name_prefix": "Mr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-09-01",
        "last_updated": "2020-09-01",
        "certification_date": "2020-09-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NC",
            "license": "A15860",
            "primary": true
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NC",
            "license": "A15860",
            "primary": false
        }
    ],
    "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 Sep 1, 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.