Individual provider Active NPI

Annette Eleanor Thompson, LCAS

  • Addiction (Substance Use Disorder) Counselor
  • Charlotte, NC
National Provider Identifier
1528319902
Registry record updated Dec 14, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
2625 Issued in NC
Practice address
616 Colonnade Dr
Charlotte, NC 28205-6827
Phone
(704) 273-3942
NPI assigned
Sep 26, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 14, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X NC
Addiction (Substance Use Disorder) Counselor 101YA0400X 2625 NC Primary

Addresses

Primary practice location

616 Colonnade Dr
Charlotte, NC 28205-6827

Mailing address

284 Executive Park Dr Ste 100
Concord, NC 28025-1833
Phone (704) 939-1100

Other practice location 1

100 Billingsley Rd
Charlotte, NC 28211
Phone (704) 376-7447

Other practice location 2

10490 Stokeshill Ct
Pineville, NC 28134-6330
Phone (704) 200-0516

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

Practice roles

OrganizationSpecialtyStatusNew patients
Daymark Recovery Services, Inc. Past Accepting new patients

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": "1348617600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702512000000",
    "number": "1528319902",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "284 EXECUTIVE PARK DR STE 100",
            "city": "CONCORD",
            "state": "NC",
            "postal_code": "280251833",
            "telephone_number": "704-939-1100",
            "fax_number": "704-939-1173"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "616 COLONNADE DR",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282056827",
            "telephone_number": "704-273-3942"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "100 Billingsley Rd",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "28211",
            "country_code": "US",
            "telephone_number": "704-376-7447",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "10490 Stokeshill Ct",
            "address_purpose": "LOCATION",
            "city": "Pineville",
            "state": "NC",
            "postal_code": "281346330",
            "country_code": "US",
            "telephone_number": "704-200-0516",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "THOMPSON",
        "first_name": "ANNETTE",
        "middle_name": "ELEANOR",
        "name_prefix": "Ms.",
        "credential": "LCAS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-09-26",
        "last_updated": "2023-12-14",
        "certification_date": "2023-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NC",
            "license": null,
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NC",
            "license": "2625",
            "primary": true
        }
    ],
    "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 Dec 14, 2023; 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.