Jessica Lynn Faulk

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

P016231 Issued in NC

Practice address

3021 Senna Dr
Matthews, NC 28105-6727

Phone

(704) 443-0144

NPI assigned

Jun 1, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Social Worker

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

The Charlotte-Mecklenburg Hospital AuthorityGroup PAC ID 2961310685, 594 clinicians

Walgren Counseling, PLLCGroup PAC ID 9638348857, 6 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Walgren Counseling, PLLC

  • Clinical Social Worker
  • Matthews, NC
  • NPI 1235422742
  Medicare reassignment Care Compare group NPD
• The Charlotte-Mecklenburg Hospital Authority

  • Medical Oncology Physician
  • Indian Land, SC
  • NPI 1669738829

  NC

  Medicare reassignment Care Compare group NPD
• The Charlotte-Mecklenburg Hospital Authority

  • Child & Adolescent Psychiatry Physician
  • Concord, NC
  • NPI 1063849420

  Clinical

  NPD
• The Charlotte-Mecklenburg Hospital Authority

  • Rehabilitation Hospital Unit
  • Charlotte, NC
  • NPI 1962987131
  NPD

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

{
    "created_epoch": "1622505600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1622505600000",
    "number": "1184290165",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1004 REGAL MANOR LN",
            "city": "FORT MILL",
            "state": "SC",
            "postal_code": "297158892",
            "telephone_number": "704-301-4670"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3021 SENNA DR",
            "city": "MATTHEWS",
            "state": "NC",
            "postal_code": "281056727",
            "telephone_number": "704-443-0144"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAULK",
        "first_name": "JESSICA",
        "middle_name": "LYNN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-06-01",
        "last_updated": "2021-06-01",
        "certification_date": "2021-06-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "P016231",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Derek Farmen
• Edith Ann Farr, APRN
• Sandra R Farrelly, RN
• Olukayode Fasuba
• Zayd Fattah
• Tarah Faust, PTA
• FBTC Transitional Sub, LLC
• FBTC Transitional Sub, LLC
• David Gerald Feeney, DDS
• Jessica Feldman, LCSW

• Clinical Social Worker in Matthews, NC
• Providers in Matthews, NC by specialty
• Clinical Social Worker in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 2021; 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.

Verify at the official NPI Registry.