Jacquelyne Aida Tingey

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

P014913 Issued in NC

Practice address

5950 Fairview Rd Ste 660
Charlotte, NC 28210-3113

Phone

(562) 310-3391

Fax

(704) 909-4009

NPI assigned

Jul 16, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1594857600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1594857600000",
    "number": "1366050239",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5950 FAIRVIEW RD STE 660",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282103113",
            "telephone_number": "562-310-3391",
            "fax_number": "704-909-4009"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5950 FAIRVIEW RD STE 660",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282103113",
            "telephone_number": "562-310-3391",
            "fax_number": "704-909-4009"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TINGEY",
        "first_name": "JACQUELYNE",
        "middle_name": "AIDA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-07-16",
        "last_updated": "2020-07-16",
        "certification_date": "2020-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "P014913",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DRIVER'S LICENSE",
            "identifier": "38981783",
            "state": "NC"
        }
    ],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "SOAP",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "5950 Fairview Rd Ste 660",
            "city": "Charlotte",
            "state": "NC",
            "country_code": "US",
            "postal_code": "282103113",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Regina M. Tindal
• Vernon Christian Paris Tindal
• Yolonda Tindal, MSW, LCSWA
• Colton Tindall, DC
• Talia Tinelli
• Jacob Bennett Tingom, PT, DPT
• Sade' Tinsley
• Ann Tinus, MA, MS, MAC, LCAS
• Tiny Wonders LLC
• Jaime K Tippett Poe, PT

• Clinical Social Worker in Charlotte, NC
• Providers in Charlotte, NC by specialty
• Clinical Social Worker in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 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.