Individual provider Active NPI

Jessica Nettles, LPC

  • Professional Counselor
  • Rock Hill, SC
National Provider Identifier
1245085844
Registry record updated May 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
10931 Issued in SC
Practice address
502 Cherry Rd Ste 201
Rock Hill, SC 29732-3118
Phone
(843) 501-1099
NPI assigned
Apr 18, 2024
Last updated
May 13, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 13, 2025

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 8449 SC
Professional Counselor 101YP2500X 10931 SC Primary

Addresses

Primary practice location

502 Cherry Rd Ste 201
Rock Hill, SC 29732-3118

Mailing address

4800 N Scottsdale Rd Ste 2500
Scottsdale, AZ 85251-7630
Phone (843) 501-1099

Other practice location 1

936 Market St
Fort Mill, SC 29708-6562
Phone (704) 502-9397

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
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

Enrollment IDStateProvider typePAC IDDetails
I20250520001116 SC Practitioner - Mental Health Counselor 2163940495 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Charleston Counseling Center PCGroup PAC ID 6204125107, 186 clinicians

Practice addresses (Care Compare)

502 Cherry Rd
Rock Hill, SC 29732-3118
Phone (843) 501-1099

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Charleston Counseling Center PC Professional CurrentSince Apr 25, 2025 Accepting new patients
Myrtle Beach Counseling Center PastSince Aug 6, 2019 Accepting new patients

Locations

4800 N Scottsdale Rd
Ste 2500
Scottsdale, AZ 85251
Phone (253) 346-0392

871 Lowcountry Blvd
Ste 200
Mt Pleasant, SC 29464
Phone (253) 346-0137

502 Cherry Rd
Rock Hill, SC 29732
Phone (839) 213-6425

502 Cherry Rd
Ste 201
Rock Hill, SC 29732
Phone (678) 763-5994

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1713398400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747094400000",
    "number": "1245085844",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4800 N SCOTTSDALE RD STE 2500",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852517630",
            "telephone_number": "843-501-1099"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "502 CHERRY RD STE 201",
            "city": "ROCK HILL",
            "state": "SC",
            "postal_code": "297323118",
            "telephone_number": "843-501-1099"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "936 Market St",
            "address_purpose": "LOCATION",
            "city": "Fort Mill",
            "state": "SC",
            "postal_code": "297086562",
            "country_code": "US",
            "telephone_number": "704-502-9397",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NETTLES",
        "first_name": "JESSICA",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-04-18",
        "last_updated": "2025-05-13",
        "certification_date": "2025-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "SC",
            "license": "8449",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "SC",
            "license": "10931",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rock Hill, SC

Sources for this page

Verify at the official NPI Registry.