Immerse & Emerge Counseling

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

Legal business name

IMMERSE & EMERGE COUNSELING

Practice address

10617 Kettering Dr Ste 113
Charlotte, NC 28226-4900

Phone

(866) 977-9067

Fax

(866) 977-9159

NPI assigned

May 20, 2020

Organization subpart

No

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

Authorized official

Name

Jessica Palacios, LPCNPI 1437527785

Title

Owner

Phone

(434) 660-5848

Specialties & licenses 1

Addresses

Electronic endpoints 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jessica Palacios, LPC

  • Mental Health Counselor
  • Lynchburg, VA
  • NPI 1437527785
  NPD Authorized official

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

{
    "created_epoch": "1589932800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1589932800000",
    "number": "1194348557",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2413 HAWTHORNE RD",
            "city": "LYNCHBURG",
            "state": "VA",
            "postal_code": "245032905",
            "telephone_number": "434-660-5848"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10617 KETTERING DR STE 113",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282264900",
            "telephone_number": "866-977-9067",
            "fax_number": "866-977-9159"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IMMERSE & EMERGE COUNSELING",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-05-20",
        "last_updated": "2020-05-20",
        "certification_date": "2020-05-20",
        "status": "A",
        "authorized_official_last_name": "PALACIOS",
        "authorized_official_first_name": "JESSICA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "434-660-5848",
        "authorized_official_credential": "LPC"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jessicapalacios@itherapymail.com",
            "affiliation": "N",
            "endpointDescription": "secure email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "10617 Kettering Dr Ste 113",
            "city": "Charlotte",
            "state": "NC",
            "country_code": "US",
            "postal_code": "282264900",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Professional Counselor in Charlotte, NC
• Providers in Charlotte, NC by specialty
• Professional Counselor in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 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.