Active NPI
Jewell Thompson, M.S, QMHP, CADC, PSS
- Addiction (Substance Use Disorder) Counselor
- Charlotte, NC
National Provider Identifier
1437534914
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction (Substance Use Disorder) Counselor
- License
- 25110
- Practice address
- 436 E 36TH St
Charlotte, NC 28205-1030 - Phone
- (704) 819-0464
- Fax
- (803) 973-0207
- NPI assigned
- Jul 24, 2015
- Last updated
- Jul 27, 2024
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 25110 | NC | Primary |
| Case Manager/Care Coordinator | 171M00000X | NU | ||
| Peer Specialist | 175T00000X | 2023-10462-01 | NC |
Addresses
Primary practice location
436 E 36TH St
Charlotte, NC 28205-1030
Mailing address
2166 Gold Hill Rd Ste 4
Fort Mill, SC 29708-9351
Phone (704) 819-0464
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
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2023-10462-01 | NC | MD | Peer Specialist |
| 25110 | NC | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lean on Me Consulting LLC | Mental Health | Current | Accepting new patients |
| Lean on Me Consulting 2 LLC | Case Manager/Care Coordinator | Current | Accepting new patients |
| Lean on Me Consulting LLC | Mental Health | Current | Accepting new patients |
Locations
436 E 36th St
Charlotte, NC 28205
Phone (704) 312-0119
1750 Highway 160 W
Ste 101304
Fort Mill, SC 29708
2166 Gold Hill Rd
Ste 4
Fort Mill, SC 29708
Phone (803) 973-0221
Organizations & group practices 3
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Case Manager/Care Coordinator
- Fort Mill, SC
- NPI 1477397289
-
- Mental Health Counselor
- Fort Mill, SC
- NPI 1063055879
-
- Mental Health Counselor
- Fort Mill, SC
- NPI 1972974608
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1437696000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1722038400000",
"number": "1437534914",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2166 GOLD HILL RD STE 4",
"city": "FORT MILL",
"state": "SC",
"postal_code": "297089351",
"telephone_number": "704-819-0464",
"fax_number": "803-973-0207"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "436 E 36TH ST",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282051030",
"telephone_number": "704-819-0464",
"fax_number": "803-973-0207"
}
],
"practiceLocations": [],
"basic": {
"last_name": "THOMPSON",
"first_name": "JEWELL",
"name_prefix": "Miss",
"credential": "M.S, QMHP, CADC, PSS",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2015-07-24",
"last_updated": "2024-07-27",
"certification_date": "2024-06-25",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "NC",
"license": "25110",
"primary": true
},
{
"code": "171M00000X",
"taxonomy_group": "",
"desc": "Case Manager/Care Coordinator",
"state": "NU",
"license": null,
"primary": false
},
{
"code": "175T00000X",
"taxonomy_group": "",
"desc": "Peer Specialist",
"state": "NC",
"license": "2023-10462-01",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Charlotte, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 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.