Jessica Jarvis, LCMHCA

Key facts

NPI

1700640398

Entity type

Individual (NPI type 1)

Primary specialty

Mental Health Counselor 101YM0800X

License

A19698 (NC)

Practice address

101 Monroe St Ste B
Carthage, NC 28327-5018

Phone

(910) 336-2904

NPI assigned

Feb 13, 2024

Sex

Female

Sole proprietor

Yes

Medicare participation

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)

No

State licenses

Specialties & licenses

Addresses

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Feb 13, 2024.

{
    "created_epoch": "1707782400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707782400000",
    "number": "1700640398",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6409 FAYETTEVILLE RD STE 120347",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277136297"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 MONROE ST STE B",
            "city": "CARTHAGE",
            "state": "NC",
            "postal_code": "283275018",
            "telephone_number": "910-336-2904"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JARVIS",
        "first_name": "JESSICA",
        "credential": "LCMHCA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-02-13",
        "last_updated": "2024-02-13",
        "certification_date": "2024-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NC",
            "license": "A19698",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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All providers in Carthage, NC · Mental Health Counselor in North Carolina