Individual provider Active NPI

Charmaine Nicole James, LPCA

  • Professional Counselor
  • Fayetteville, NC
National Provider Identifier
1487128013
Registry record updated Jul 29, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
13689 Issued in NC
Practice address
2151 Skibo Rd
Fayetteville, NC 28314-0252
Phone
(910) 689-5333
NPI assigned
Jan 16, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 29, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X LCAS-24238 NC
Professional Counselor 101YP2500X A13689 NC
Professional Counselor 101YP2500X 13689 NC Primary

Addresses

Primary practice location

2151 Skibo Rd
Fayetteville, NC 28314-0252

Mailing address

1930 Harcourt Cir Apt 103
Fayetteville, NC 28304-0585
Phone (910) 882-4424

Other practice location 1

1930 Harcourt Cir Apt 103
Fayetteville, NC 28304-0585
Phone (910) 882-4424

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241231002749 NC Practitioner - Mental Health Counselor 3678000742 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LCAS-24238NCMDAddiction (Substance Use Disorder) Counselor
A13689NCMDProfessional Counselor
13689NCMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Destined 2 Thrive LLC Professional CurrentSince Nov 1, 2024 Accepting new patients
Carter Clinic PA Addiction (Substance Use Disorder) CurrentSince Jan 1, 2025 Accepting new patients
Cape Fear Behavioral Health Center LLC Addiction (Substance Use Disorder) PastSince Apr 20, 2026 Accepting new patients
Carter Clinic, P.a. PastSince Mar 4, 2021 Accepting new patients
Carter Clinic PA PastSince Mar 4, 2021 Accepting new patients
Carter Clinic, PA Past Accepting new patients

Locations

4009 Barrett Dr
Ste 102
Raleigh, NC 27609

Organizations & group practices 7

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.

NPI Registry JSON

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

{
    "created_epoch": "1547596800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1627516800000",
    "number": "1487128013",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1930 HARCOURT CIR APT 103",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283040585",
            "telephone_number": "910-882-4424"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2151 SKIBO RD",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283140252",
            "telephone_number": "910-689-5333"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1930 Harcourt Cir Apt 103",
            "address_purpose": "LOCATION",
            "city": "Fayetteville",
            "state": "NC",
            "postal_code": "283040585",
            "country_code": "US",
            "telephone_number": "910-882-4424",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JAMES",
        "first_name": "CHARMAINE",
        "middle_name": "NICOLE",
        "name_prefix": "Ms.",
        "credential": "LPCA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-01-16",
        "last_updated": "2021-07-29",
        "certification_date": "2021-07-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NC",
            "license": "LCAS-24238",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NC",
            "license": "A13689",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NC",
            "license": "13689",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fayetteville, NC

Sources for this page

Verify at the official NPI Registry.