Jesse Hazel, LCSWA, LCASA

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

P010570 Issued in NC

Practice address

1308 Highland Dr
Washington, NC 27889-3424

Phone

(252) 946-3666

Fax

(252) 945-5499

NPI assigned

Oct 13, 2016

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NC

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

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 and National Provider Directory roles.

• Vidant Medical Group LLC

  • Multi-Specialty Clinic/Center
  • Greenville, NC
  • NPI 1477648731
  NPD
• Alchemy Counseling, Consultation, and Wellness

  • Professional Counselor
  • Fort Collins, CO
  • NPI 1003672387

  Clinical

  NPD (past)
• Four Points Counseling Center LLC

  • Professional Counselor
  • Fort Collins, CO
  • NPI 1407429350

  Addiction (Substance Use Disorder)

  NPD (past)

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

{
    "created_epoch": "1476316800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1476316800000",
    "number": "1972053973",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1308 HIGHLAND DR",
            "city": "WASHINGTON",
            "state": "NC",
            "postal_code": "278893424",
            "telephone_number": "252-946-3666",
            "fax_number": "252-945-5499"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1308 HIGHLAND DR",
            "city": "WASHINGTON",
            "state": "NC",
            "postal_code": "278893424",
            "telephone_number": "252-946-3666",
            "fax_number": "252-945-5499"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAZEL",
        "first_name": "JESSE",
        "credential": "LCSWA, LCASA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-10-13",
        "last_updated": "2016-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NC",
            "license": "LCAS-22936",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "P010570",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kirk Randall Harris, O.D.
• Brandi Cahoon Harrison, PHARM.D.
• Chelsea Hassell
• Haven of Positive Enrichment, Inc.
• Stephanie J Hayesharris, LPA
• Jennifer Nichole Head
• Healthaccess, Inc.
• Healthnow, P.a.
• Healthplus Therapeutic Services Inc
• Healthplus Therapeutic Services Inc

• All providers in Washington, NC
• Clinical Social Worker in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.