Nicole Ann Radcliff

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

A19238 Issued in NC

Practice address

10 Dewitt St
Jacksonville, NC 28540-5649

Phone

(334) 805-6144

NPI assigned

Nov 3, 2023

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Ms. Nicole Ann Tefft Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1698969600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1700092800000",
    "number": "1699548461",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "759 JIM GRANT AVE",
            "city": "SNEADS FERRY",
            "state": "NC",
            "postal_code": "284606793",
            "telephone_number": "334-805-6144"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 DEWITT ST",
            "city": "JACKSONVILLE",
            "state": "NC",
            "postal_code": "285405649",
            "telephone_number": "334-805-6144"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RADCLIFF",
        "first_name": "NICOLE",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-11-03",
        "last_updated": "2023-11-16",
        "certification_date": "2023-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NC",
            "license": "A19238",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "NICOLE",
            "last_name": "TEFFT",
            "middle_name": "ANN",
            "prefix": "MS.",
            "credential": "NICOLE FENDER",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Feliciana Inocenta Quinn
• Cale Robert Quintero
• Stephanie Marie Quist, APRN, PMHNP-BC
• R & R Counseling Services PLLC
• Eleanor E Radcliff, LCMHCA
• Sybil Annette Rains, OTR/L
• Gabrielle Elizabeth Rakidzich, AUD
• Leah Annette Ramey, M.ED, MSW, LCSW
• Samantha K Ramirez
• Steve Krishna Ramlogan, IDC

• Mental Health Counselor in Jacksonville, NC
• Providers in Jacksonville, NC by specialty
• Mental Health Counselor in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 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.