Individual provider Active NPI

Jessica Nadine Larue, LMFTA

  • Marriage & Family Therapist
  • Albemarle, NC
National Provider Identifier
1336677095
Registry record updated Jul 1, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
12021A Issued in NC
Practice address
215 3Rd Ave
Albemarle, NC 28001-4409
Phone
(980) 581-4305
NPI assigned
May 25, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 1, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 12021A NC Primary

Addresses

Primary practice location

215 3Rd Ave
Albemarle, NC 28001-4409

Mailing address

215 3Rd Ave
Albemarle, NC 28001-4409
Phone (704) 640-3487

Other practice location 1

700 Church St N Ste 70
Concord, NC 28025-4380
Phone (704) 918-1343

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
12021ANCMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
West Counseling PastSince Sep 1, 2012 Accepting new patients

Interoperability endpoints

  • Direct secure messaging: jessica.larue.p1@direct.daymarkrecovery.nextgenshare.com

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1495670400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1593561600000",
    "number": "1336677095",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "215 3RD AVE",
            "city": "ALBEMARLE",
            "state": "NC",
            "postal_code": "280014409",
            "telephone_number": "704-640-3487"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "215 3RD AVE",
            "city": "ALBEMARLE",
            "state": "NC",
            "postal_code": "280014409",
            "telephone_number": "980-581-4305"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "700 Church St N Ste 70",
            "address_purpose": "LOCATION",
            "city": "Concord",
            "state": "NC",
            "postal_code": "280254380",
            "country_code": "US",
            "telephone_number": "704-918-1343",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LARUE",
        "first_name": "JESSICA",
        "middle_name": "NADINE",
        "credential": "LMFTA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-05-25",
        "last_updated": "2020-07-01",
        "certification_date": "2020-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "NC",
            "license": "12021A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Albemarle, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2020; 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.