Active NPI
Amber Cochran Threatt, MA, LPC, LCAS
- Professional Counselor
- Concord, NC
National Provider Identifier
1700211604
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 10198
- Practice address
- 250 Branchview Dr NE
Concord, NC 28025-3415 - Phone
- (980) 621-8538
- Fax
- (704) 870-3230
- NPI assigned
- Sep 10, 2013
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | LCAS-3519 | NC | |
| Professional Counselor | 101YP2500X | 10198 | NC | Primary |
Addresses
Primary practice location
250 Branchview Dr NE
Concord, NC 28025-3415
Mailing address
802 Fargo Dr SW
Concord, NC 28027-6936
Phone (980) 621-8538
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LCAS-3519 | NC | MD | Addiction (Substance Use Disorder) Counselor |
| 10198 | NC | MD | Periodontist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1378771200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1657152000000",
"number": "1700211604",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "802 FARGO DR SW",
"city": "CONCORD",
"state": "NC",
"postal_code": "280276936",
"telephone_number": "980-621-8538",
"fax_number": "704-870-3230"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "250 BRANCHVIEW DR NE",
"city": "CONCORD",
"state": "NC",
"postal_code": "280253415",
"telephone_number": "980-621-8538",
"fax_number": "704-870-3230"
}
],
"practiceLocations": [],
"basic": {
"last_name": "THREATT",
"first_name": "AMBER",
"middle_name": "COCHRAN",
"credential": "MA, LPC, LCAS",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2013-09-10",
"last_updated": "2022-07-07",
"certification_date": "2022-07-07",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "NC",
"license": "LCAS-3519",
"primary": false
},
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "NC",
"license": "10198",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Concord, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.