Active NPI
Jamie Myron Washington, LPC-A
- Mental Health Counselor
- Wilmington, NC
National Provider Identifier
1376997015
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- A12309
- Practice address
- 615 Shipyard Blvd
Wilmington, NC 28412-6431 - Phone
- (910) 202-3155
- Fax
- (910) 202-5772
- NPI assigned
- Apr 19, 2016
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | LCAS-22503 | NC | |
| Mental Health Counselor | 101YM0800X | A12309 | NC | Primary |
Addresses
Primary practice location
615 Shipyard Blvd
Wilmington, NC 28412-6431
Mailing address
615 Shipyard Blvd
Wilmington, NC 28412-6431
Phone (910) 202-3155
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 |
|---|---|---|---|
| LCAS-22503 | NC | MD | Addiction (Substance Use Disorder) Counselor |
| A12309 | NC | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1461024000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1461024000000",
"number": "1376997015",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "615 SHIPYARD BLVD",
"city": "WILMINGTON",
"state": "NC",
"postal_code": "284126431",
"telephone_number": "910-202-3155",
"fax_number": "910-202-5772"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "615 SHIPYARD BLVD",
"city": "WILMINGTON",
"state": "NC",
"postal_code": "284126431",
"telephone_number": "910-202-3155",
"fax_number": "910-202-5772"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WASHINGTON",
"first_name": "JAMIE",
"middle_name": "MYRON",
"name_prefix": "Mr.",
"credential": "LPC-A",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2016-04-19",
"last_updated": "2016-04-19",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "NC",
"license": "LCAS-22503",
"primary": false
},
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "NC",
"license": "A12309",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Wilmington, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.