Tanisha R James, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

C005793 Issued in NC

Practice address

351 Wagoner Dr
Suite 310
Fayetteville, NC 28303-4608

Phone

(910) 475-8888

NPI assigned

Nov 30, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Legacy Counseling & Consulting Group, PLLC

  • Clinical Social Worker
  • Fayetteville, NC
  • NPI 1730406935
  NPD (past) Authorized official

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

{
    "created_epoch": "1196380800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1472169600000",
    "number": "1205018355",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 25238",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283145003",
            "telephone_number": "704-726-1270",
            "fax_number": "866-462-1782"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "351 WAGONER DR",
            "address_2": "SUITE 310",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283034608",
            "telephone_number": "910-475-8888"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JAMES",
        "first_name": "TANISHA",
        "middle_name": "R",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-11-30",
        "last_updated": "2016-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "C005793",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "SC",
            "license": "9295",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6106806",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Dominic Xavier James
• Naeema Ali James
• Natalie M James
• Pamela T James, LPN
• Sindu James, RPH
• Theady Earl James III, LMT
• Marium Jamil, MD
• Amy M Jamison
• Kasia Janey
• Kelly Jansen

• Clinical Social Worker in Fayetteville, NC
• Providers in Fayetteville, 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 Aug 26, 2016; 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.