Jamarr J Funderburg, LCSW, LCAS, CCS

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

C005599 Issued in NC

Practice address

1905 J N Pease PL Ste 202
Charlotte, NC 28262-4539

Phone

(704) 771-4633

NPI assigned

Feb 6, 2007

Last updated

Oct 24, 2018By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

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

Locations

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.

• Charlotte Counseling and Consulting, PLLC

  • Mental Illness Community Based Residential Treatment Facility
  • Charlotte, NC
  • NPI 1467782177

  Addiction (Substance Use Disorder)

  NPD Authorized official
• Charlotte Counseling and Consulting, PLLC

  • Community/Behavioral Health Agency
  • Charlotte, NC
  • NPI 1548796766

  Clinical

  NPD Authorized official

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

{
    "created_epoch": "1170720000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1540339200000",
    "number": "1871632430",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1905 J N PEASE PL STE 202",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282624539",
            "telephone_number": "704-771-4633"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1905 J N PEASE PL STE 202",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282624539",
            "telephone_number": "704-771-4633"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1909 J N Pease Pl",
            "address_2": "Suite 103",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282624544",
            "country_code": "US",
            "telephone_number": "704-547-6219",
            "fax_number": "980-225-5555",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FUNDERBURG",
        "first_name": "JAMARR",
        "middle_name": "J",
        "credential": "LCSW, LCAS, CCS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-06",
        "last_updated": "2018-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NC",
            "license": "1184",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "C005599",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LCSW",
            "identifier": "C005599",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LCAS",
            "identifier": "1184",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Function and Performance Chiropractic
• Functionalcare 360
• Fund-a-Mental in Education Training & Consulting
• Fundamental Physical Therapy LLC
• Amanda Hudgins Funderburg, PHARMD
• Teneika Clifton Funderburk
• Manuela Fungate
• Susan Elizabeth Funk, PSY.D.
• Jennifer Reed Funsten, RD
• Matthew Neil Fuquay, PA

• 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 Oct 24, 2018; 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.