Individual provider Active NPI

James H Southern Jr., LPC

  • Mental Health Counselor
  • Nags Head, NC
National Provider Identifier
1285708412
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
3091 Issued in NC
Practice address
2808 S Croatan Hwy
Suite a
Nags Head, NC 27959-9024
Phone
(252) 449-4011
Fax
(252) 449-4050
NPI assigned
Nov 20, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 3091 NC Primary
Professional Counselor 101YP2500X 3091 NC

Addresses

Primary practice location

2808 S Croatan Hwy
Suite a
Nags Head, NC 27959-9024

Mailing address

170 Sherwood Dr
Manteo, NC 27954-9569
Phone (252) 473-6436

Other identifiers 2

IdentifierTypeStateIssuer
138TYOtherNCBCBS PROVIDER NUMBER
6102181MedicaidNC

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

LicenseStateTypeSpecialty
3091NCMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1163980800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1285708412",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "170 SHERWOOD DR",
            "city": "MANTEO",
            "state": "NC",
            "postal_code": "279549569",
            "telephone_number": "252-473-6436"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2808 S CROATAN HWY",
            "address_2": "SUITE A",
            "city": "NAGS HEAD",
            "state": "NC",
            "postal_code": "279599024",
            "telephone_number": "252-449-4011",
            "fax_number": "252-449-4050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOUTHERN",
        "first_name": "JAMES",
        "middle_name": "H",
        "name_suffix": "Jr.",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-20",
        "last_updated": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NC",
            "license": "3091",
            "primary": true
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NC",
            "license": "3091",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS PROVIDER NUMBER",
            "identifier": "138TY",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6102181",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Nags Head, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; 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.