Active NPI
Julissa Edwards
- Mental Health Counselor
- Charlotte, NC
National Provider Identifier
1255875563
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- P04032
- Practice address
- 11835 Planters Estates Dr
Charlotte, NC 28278-0200 - Phone
- (914) 299-0066
- NPI assigned
- Dec 6, 2016
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | P04032 | NY | Primary |
Addresses
Primary practice location
11835 Planters Estates Dr
Charlotte, NC 28278-0200
Mailing address
11835 Planters Estates Dr
Charlotte, NC 28278-0200
Phone (914) 299-0066
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 |
|---|---|---|---|
| P04032 | NY | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1480982400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1688601600000",
"number": "1255875563",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11835 PLANTERS ESTATES DR",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282780200",
"telephone_number": "914-299-0066"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11835 PLANTERS ESTATES DR",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282780200",
"telephone_number": "914-299-0066"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EDWARDS",
"first_name": "JULISSA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-12-06",
"last_updated": "2023-07-06",
"certification_date": "2023-07-06",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "NY",
"license": "P04032",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Charlotte, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 6, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.