Active NPI
Jesse Jacob Lile, M.A.
- Professional Counselor
- Winston Salem, NC
National Provider Identifier
1801068440
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 6731
- Practice address
- 5000 Country Club Rd.
Winston Salem, NC 27104 - Phone
- (336) 714-5478
- NPI assigned
- Mar 24, 2008
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 6731 | NC | Primary |
| Marriage & Family Therapist | 106H00000X |
Addresses
Primary practice location
5000 Country Club Rd.
Winston Salem, NC 27104
Mailing address
1122 Melrose St
Winston Salem, NC 27103-4437
Phone (336) 722-8235
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 |
|---|---|---|---|
| 6731 | NC | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1206316800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1206316800000",
"number": "1801068440",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1122 MELROSE ST",
"city": "WINSTON SALEM",
"state": "NC",
"postal_code": "271034437",
"telephone_number": "336-722-8235"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5000 COUNTRY CLUB RD.",
"city": "WINSTON SALEM",
"state": "NC",
"postal_code": "27104",
"telephone_number": "336-714-5478"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LILE",
"first_name": "JESSE",
"middle_name": "JACOB",
"credential": "M.A.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2008-03-24",
"last_updated": "2008-03-24",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "NC",
"license": "6731",
"primary": true
},
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": null,
"license": null,
"primary": false
}
],
"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 Mar 24, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.