Active NPI
Jaxson Judkins, PHD
- Mental Health Counselor
- Cary, NC
National Provider Identifier
1720894793
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- A2030
- Practice address
- 2000 Regency Pkwy Ste 285
Cary, NC 27518-8506 - Phone
- (919) 234-6144
- NPI assigned
- Dec 5, 2024
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | A2030 | NC | Primary |
Addresses
Primary practice location
2000 Regency Pkwy Ste 285
Cary, NC 27518-8506
Mailing address
174 Hunston Dr
Holly Springs, NC 27540-6056
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
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A2030 | NC | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1733356800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1733356800000",
"number": "1720894793",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "174 HUNSTON DR",
"city": "HOLLY SPRINGS",
"state": "NC",
"postal_code": "275406056"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2000 REGENCY PKWY STE 285",
"city": "CARY",
"state": "NC",
"postal_code": "275188506",
"telephone_number": "919-234-6144"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JUDKINS",
"first_name": "JAXSON",
"name_prefix": "Dr.",
"credential": "PHD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2024-12-05",
"last_updated": "2024-12-05",
"certification_date": "2024-11-25",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "NC",
"license": "A2030",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Cary, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.