Active NPI
Jennifer Parks Rezeli, LPC, LCASA
- Professional Counselor
- Greenville, NC
National Provider Identifier
1669870416
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 9674
- Practice address
- 2602 Courtier Dr
Greenville, NC 27834-7818 - Phone
- (252) 752-0483
- Fax
- (252) 757-3172
- NPI assigned
- Dec 10, 2014
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 9674 | NC | Primary |
Addresses
Primary practice location
2602 Courtier Dr
Greenville, NC 27834-7818
Mailing address
4300 Sapphire CT Ste 110
Greenville, NC 27834-9079
Phone (252) 830-7540
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 9674 | NC | MD | Orthopedic Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1418169600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1435708800000",
"number": "1669870416",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4300 SAPPHIRE CT STE 110",
"city": "GREENVILLE",
"state": "NC",
"postal_code": "278349079",
"telephone_number": "252-830-7540",
"fax_number": "252-413-0932"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2602 COURTIER DR",
"city": "GREENVILLE",
"state": "NC",
"postal_code": "278347818",
"telephone_number": "252-752-0483",
"fax_number": "252-757-3172"
}
],
"practiceLocations": [],
"basic": {
"last_name": "REZELI",
"first_name": "JENNIFER",
"middle_name": "PARKS",
"credential": "LPC, LCASA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-12-10",
"last_updated": "2015-07-01",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "NC",
"license": "9674",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Greenville, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.