Jessica Pegram, LCSWA

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

P018732 Issued in NC

Practice address

410 Legacy Dr
Youngsville, NC 27596-7985

Phone

(762) 822-8595

NPI assigned

Apr 9, 2025

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

Interoperability endpoints

• Direct secure messaging: jessica.pegram.1@33587.direct.athenahealth.com

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

{
    "created_epoch": "1744156800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744156800000",
    "number": "1922893155",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "410 LEGACY DR",
            "city": "YOUNGSVILLE",
            "state": "NC",
            "postal_code": "275967985"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "410 LEGACY DR",
            "city": "YOUNGSVILLE",
            "state": "NC",
            "postal_code": "275967985",
            "telephone_number": "762-822-8595"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEGRAM",
        "first_name": "JESSICA",
        "credential": "LCSWA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-04-09",
        "last_updated": "2025-04-09",
        "certification_date": "2025-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "P018732",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Daphne Papageorge, BCBA
• Alexandra Deanne Papathakis, M.S. CCC-SLP
• Nirali Patel
• Priya Patel, OD
• Kelly Pearce Moore, RN
• Tyrese Leon Perry
• Angela Phan, MA, LPA
• Dan M Phillips, MD
• Tanya Donnella Pleasent
• Polaris Rehabilitation, LLC

• Clinical Social Worker in Youngsville, NC
• Providers in Youngsville, 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 Apr 9, 2025; 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.