Individual provider Active NPI

Jamie Jackson Pridgen, M.A, LPC

  • Professional Counselor
  • Charlotte, NC
National Provider Identifier
1659530483
Registry record updated Jun 6, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
6393 Issued in NC
Practice address
700 N Tryon St
Charlotte, NC 28202-2222
Phone
(704) 336-5053
Fax
(704) 336-4198
NPI assigned
Jun 6, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 6, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 6393 NC Primary

Addresses

Primary practice location

700 N Tryon St
Charlotte, NC 28202-2222

Mailing address

700 N Tryon St
Charlotte, NC 28202-2222
Phone (704) 336-5053

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 Arts

NPI Registry JSON

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

{
    "created_epoch": "1212710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1212710400000",
    "number": "1659530483",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 N TRYON ST",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282022222",
            "telephone_number": "704-336-5053",
            "fax_number": "704-336-4198"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 N TRYON ST",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282022222",
            "telephone_number": "704-336-5053",
            "fax_number": "704-336-4198"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRIDGEN",
        "first_name": "JAMIE",
        "middle_name": "JACKSON",
        "name_prefix": "Ms.",
        "credential": "M.A, LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-06-06",
        "last_updated": "2008-06-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NC",
            "license": "6393",
            "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 Jun 6, 2008; 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.