NPIMap

Organization Active NPI

Jacob's Ladder Childhood Therapy

  • Counselor
  • Clayton, NC
National Provider Identifier
1750695730
Registry record updated Aug 9, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
License
4543 Issued in NC
Legal business name
JACOB'S LADDER CHILDHOOD THERAPY
Practice address
8928 US Highway 70 W
Suite 100
Clayton, NC 27520-4844
Phone
(919) 217-2929
Fax
(919) 217-2993
NPI assigned
Aug 2, 2010
Last updated
Aug 9, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 9, 2010

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

Authorized official

Name
Rita June Terrago, PHD, ABD, LPC
Title
Owner/Director
Phone
(919) 217-2929

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X 4543 NC Primary

Addresses

Primary practice location

8928 US Highway 70 W
Suite 100
Clayton, NC 27520-4844

Mailing address

8928 US Highway 70 W
Suite 100
Clayton, NC 27520-4844
Phone (919) 217-2929

Other identifiers 1

IdentifierTypeStateIssuer
1447444096MedicaidNC

National Provider Directory

National Provider Directory

Locations

8928 US Highway 70 W
Ste 100
Clayton, NC 27520
Phone (919) 217-2929

NPI Registry JSON

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

{
    "created_epoch": "1280707200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1281312000000",
    "number": "1750695730",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8928 US HIGHWAY 70 W",
            "address_2": "SUITE 100",
            "city": "CLAYTON",
            "state": "NC",
            "postal_code": "275204844",
            "telephone_number": "919-217-2929",
            "fax_number": "919-217-2993"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8928 US HIGHWAY 70 W",
            "address_2": "SUITE 100",
            "city": "CLAYTON",
            "state": "NC",
            "postal_code": "275204844",
            "telephone_number": "919-217-2929",
            "fax_number": "919-217-2993"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JACOB'S LADDER CHILDHOOD THERAPY",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-08-02",
        "last_updated": "2010-08-09",
        "status": "A",
        "authorized_official_last_name": "TERRAGO",
        "authorized_official_first_name": "RITA",
        "authorized_official_middle_name": "JUNE",
        "authorized_official_title_or_position": "OWNER/DIRECTOR",
        "authorized_official_telephone_number": "919-217-2929",
        "authorized_official_credential": "PHD, ABD, LPC"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "NC",
            "license": "4543",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1447444096",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Clayton, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2010; 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.