Active NPI
Jamillah Fitzgerald, LCAS-A
- Addiction (Substance Use Disorder) Counselor
- Charlotte, NC
National Provider Identifier
1871216473
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction (Substance Use Disorder) Counselor
- License
- 31721
- Practice address
- 428 E 4TH St Ste 404
Charlotte, NC 28202-2497 - Phone
- (704) 919-1335
- NPI assigned
- Sep 20, 2022
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 31721 | NC | Primary |
Addresses
Primary practice location
428 E 4TH St Ste 404
Charlotte, NC 28202-2497
Mailing address
1421 Thompson Ave
Charlotte, NC 28216-1538
Phone (704) 712-6141
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 |
|---|---|---|---|
| CADC-23772 | NC | MD | Addiction (Substance Use Disorder) Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1663632000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1787443200000",
"number": "1871216473",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1421 THOMPSON AVE",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282161538",
"telephone_number": "704-712-6141"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "428 E 4TH ST STE 404",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282022497",
"telephone_number": "704-919-1335"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FITZGERALD",
"first_name": "JAMILLAH",
"credential": "LCAS-A",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-09-20",
"last_updated": "2026-08-23",
"certification_date": "2026-08-23",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "NC",
"license": "31721",
"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 Aug 23, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.