Active NPI
Brandon Andre Jevon James, LCMHC,LCAS-A, CRC
- Mental Health Counselor
- Winston Salem, NC
National Provider Identifier
1194239665
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 13179
- Practice address
- 1922 S Martin Luther King Jr Dr Ste 225
Winston Salem, NC 27107-1361 - Phone
- (336) 464-3136
- Fax
- (336) 734-6917
- NPI assigned
- Nov 20, 2017
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 23683 | NC | |
| Rehabilitation Counselor | 225C00000X | 00188145 | NC | |
| Mental Health Counselor | 101YM0800X | 13179 | NC | Primary |
Addresses
Primary practice location
1922 S Martin Luther King Jr Dr Ste 225
Winston Salem, NC 27107-1361
Mailing address
4626 West Market Street Suite C PO Box 229
Greensboro, NC 27407
Phone (336) 814-6524
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 |
|---|---|---|---|
| 13179 | NC | MD | Pharmacist |
| 23683 | NC | MD | Pharmacist |
| 00188145 | NC | MD | Rehabilitation Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Knew Era Consulting PLLC | Addiction (Substance Use Disorder) | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Community/Behavioral Health Agency
- Winston Salem, NC
- NPI 1912446253
Addiction (Substance Use Disorder)
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1511136000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1615939200000",
"number": "1194239665",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4626 WEST MARKET STREET SUITE C PO BOX 229",
"city": "GREENSBORO",
"state": "NC",
"postal_code": "27407",
"telephone_number": "336-814-6524",
"fax_number": "336-355-9619"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1922 S MARTIN LUTHER KING JR DR STE 225",
"city": "WINSTON SALEM",
"state": "NC",
"postal_code": "271071361",
"telephone_number": "336-464-3136",
"fax_number": "336-734-6917"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JAMES",
"first_name": "BRANDON",
"middle_name": "ANDRE JEVON",
"name_prefix": "Mr.",
"credential": "LCMHC,LCAS-A, CRC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2017-11-20",
"last_updated": "2021-03-17",
"certification_date": "2020-11-17",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "NC",
"license": "23683",
"primary": false
},
{
"code": "225C00000X",
"taxonomy_group": "",
"desc": "Rehabilitation Counselor",
"state": "NC",
"license": "00188145",
"primary": false
},
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "NC",
"license": "13179",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Winston Salem, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.