Laurie Amy Jachym, L.C.S.W.

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

C006129 Issued in NC

Practice address

811 Central Ave
Suite 7
Charlotte, NC 28204-2032

Phone

(704) 575-0626

Fax

(704) 612-8204

NPI assigned

Jan 17, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Meridian Counseling Group PLLC

  • Mental Health Counselor
  • Charlotte, NC
  • NPI 1821320086
  NPD (past)
• Transformative Life Center, LLC.

  • Psychologist
  • Matthews, NC
  • NPI 1215259874
  NPD (past)

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

{
    "created_epoch": "1168992000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1312156800000",
    "number": "1841342185",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "811 CENTRAL AVE",
            "address_2": "SUITE 7",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282042032",
            "telephone_number": "704-575-0626",
            "fax_number": "704-612-8204"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "811 CENTRAL AVE",
            "address_2": "SUITE 7",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282042032",
            "telephone_number": "704-575-0626",
            "fax_number": "704-612-8204"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACHYM",
        "first_name": "LAURIE",
        "middle_name": "AMY",
        "name_prefix": "Ms.",
        "credential": "L.C.S.W.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-17",
        "last_updated": "2011-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "C006129",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SOCIAL WORK CERTIFICATION AND LICENSURE BOARD (LCSW)",
            "identifier": "C006129",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6007031",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jad Jabbour
• Scott Leonard Jaben, MD
• Amanie Jaber
• Luma Jaber, DMD
• Gretchen M Jachim, PA-C
• Shelby Lynn Jackloski, MM, MS, CCC-SLP
• Sarah Kathleen Jacks, LPCA
• Jackson Consulting and Services LLC
• Jackson Family Homes, Inc.
• Jackson Family Homes, Inc.

• Clinical Social Worker in Charlotte, NC
• Providers in Charlotte, NC by specialty
• Clinical Social Worker in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2011; 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.