Active NPI
James Clifton Anderson, LPC, LCAS
- Professional Counselor
- Charlotte, NC
National Provider Identifier
1811010622
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 4938
- Practice address
- 1409 East Blvd
Suite 100
Charlotte, NC 28203-5817 - Phone
- (704) 338-1155
- Fax
- (704) 342-1917
- NPI assigned
- Apr 8, 2007
- Last updated
- Jul 8, 2007
- 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 |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 4938 | NC | Primary |
Addresses
Primary practice location
1409 East Blvd
Suite 100
Charlotte, NC 28203-5817
Mailing address
145 Spinnaker CT
Davidson, NC 28036-7102
Phone (704) 896-5759
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
| License | State | Type | Specialty |
|---|---|---|---|
| 4938 | NC | MD | Occupational Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Impact Carolina Services, Inc | Professional | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1175990400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1811010622",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "145 SPINNAKER CT",
"city": "DAVIDSON",
"state": "NC",
"postal_code": "280367102",
"telephone_number": "704-896-5759",
"fax_number": "704-342-1917"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1409 EAST BLVD",
"address_2": "SUITE 100",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282035817",
"telephone_number": "704-338-1155",
"fax_number": "704-342-1917"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ANDERSON",
"first_name": "JAMES",
"middle_name": "CLIFTON",
"credential": "LPC, LCAS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-04-08",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "NC",
"license": "4938",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Charlotte, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.