Kadeedrah Pridgen, LCMHCA

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

LCAS-29382 Issued in NC

Practice address

6111 Bulltown Rd
La Grange, NC 28551-7272

Phone

(404) 915-9998

NPI assigned

Oct 25, 2023

Last updated

Oct 25, 2023By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1698192000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698192000000",
    "number": "1922870716",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6111 BULLTOWN RD",
            "city": "LA GRANGE",
            "state": "NC",
            "postal_code": "285517272",
            "telephone_number": "404-915-9998"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6111 BULLTOWN RD",
            "city": "LA GRANGE",
            "state": "NC",
            "postal_code": "285517272",
            "telephone_number": "404-915-9998"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRIDGEN",
        "first_name": "KADEEDRAH",
        "credential": "LCMHCA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-10-25",
        "last_updated": "2023-10-25",
        "certification_date": "2023-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NC",
            "license": "LCAS-29382",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Marjorie R Rachide, FNP
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• Laura W Shearer, RN, MSN
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• Addiction (Substance Use Disorder) Counselor in La Grange, NC
• Providers in La Grange, NC by specialty
• Addiction (Substance Use Disorder) Counselor in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2023; 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.