NPIMap

Individual provider Active NPI

Jessica Coble

  • Professional Counselor
  • Winston Salem, NC
National Provider Identifier
1750844437
Registry record updated Apr 10, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
A14713 Issued in NC
Practice address
510 Northgate Park Dr
Winston Salem, NC 27106-3486
Phone
(336) 276-2076
NPI assigned
Apr 10, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 10, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X A14713 NC Primary

Addresses

Primary practice location

510 Northgate Park Dr
Winston Salem, NC 27106-3486

Mailing address

6302 Cloud Rd
Julian, NC 27283-9116
Phone (336) 430-7882

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

State licenses

LicenseStateTypeSpecialty
A14713NCMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Grateful Life Counseling PLLC Current Accepting new patients
Rising Hope Clinical Assistance, LLC Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1554854400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1554854400000",
    "number": "1750844437",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6302 CLOUD RD",
            "city": "JULIAN",
            "state": "NC",
            "postal_code": "272839116",
            "telephone_number": "336-430-7882"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "510 NORTHGATE PARK DR",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271063486",
            "telephone_number": "336-276-2076"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COBLE",
        "first_name": "JESSICA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-04-10",
        "last_updated": "2019-04-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NC",
            "license": "A14713",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Winston Salem, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2019; 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.