Active NPI
Lesley Audra Foulkes-Jamison, PH.D.
- Clinical Psychologist
- Irmo, SC
National Provider Identifier
1609901743
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 803
- Practice address
- 1180 Columbia Ave
Suite 201
Irmo, SC 29063-2852 - Phone
- (803) 407-5920
- NPI assigned
- Feb 22, 2007
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 803 | SC | Primary |
Addresses
Primary practice location
1180 Columbia Ave
Suite 201
Irmo, SC 29063-2852
Mailing address
1180 Columbia Ave
Suite 201
Irmo, SC 29063-2852
Phone (803) 407-5920
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| PS0333 | Medicaid | SC |
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)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 803 | SC | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ernest J Bordini PHD & Assoc PA | Clinical | 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": "1172102400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183939200000",
"number": "1609901743",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1180 COLUMBIA AVE",
"address_2": "SUITE 201",
"city": "IRMO",
"state": "SC",
"postal_code": "290632852",
"telephone_number": "803-407-5920"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1180 COLUMBIA AVE",
"address_2": "SUITE 201",
"city": "IRMO",
"state": "SC",
"postal_code": "290632852",
"telephone_number": "803-407-5920"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FOULKES-JAMISON",
"first_name": "LESLEY",
"middle_name": "AUDRA",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-02-22",
"last_updated": "2007-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "SC",
"license": "803",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "PS0333",
"state": "SC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Irmo, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.