NPIMap

Organization Active NPI

Blu Jaae Counseling Services

  • Professional Counselor
  • Winston Salem, NC
National Provider Identifier
1316765480
Registry record updated Sep 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
Legal business name
BLU JAAE COUNSELING SERVICES
Practice address
615 Saint George Square CT
Ste 300
Winston Salem, NC 27103-1368
Phone
(252) 518-5223
NPI assigned
Sep 28, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 28, 2024

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

Authorized official

Name
Mrs. Ebonee Pertrice Edwards, MS, CRC, LCMHC, ALCNPI 1093190050
Title
Owner/Lead Therapist
Phone
(252) 518-5223

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YP2500X Primary

Addresses

Primary practice location

615 Saint George Square CT
Ste 300
Winston Salem, NC 27103-1368

Mailing address

615 Saint George Square CT
Ste 300
Winston Salem, NC 27103-1368
Phone (252) 518-5223

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1727481600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1727481600000",
    "number": "1316765480",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "615 SAINT GEORGE SQUARE CT",
            "address_2": "STE 300",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271031368",
            "telephone_number": "252-518-5223"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "615 SAINT GEORGE SQUARE CT",
            "address_2": "STE 300",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271031368",
            "telephone_number": "252-518-5223"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLU JAAE COUNSELING SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-09-28",
        "last_updated": "2024-09-28",
        "certification_date": "2024-09-28",
        "status": "A",
        "authorized_official_last_name": "EDWARDS",
        "authorized_official_first_name": "EBONEE",
        "authorized_official_middle_name": "PERTRICE",
        "authorized_official_title_or_position": "OWNER/LEAD THERAPIST",
        "authorized_official_telephone_number": "252-518-5223",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "MS, CRC, LCMHC, ALC"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Winston Salem, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2024; 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.