Roland Jimmy Paulk, M.A.,CCC,LPC,LCASA

Primary specialty

CounselorTaxonomy code 101Y00000X

License

8955 Issued in NC

Practice address

205 Memorial Drive
Pinehurst, NC 28370-8712

Phone

(910) 295-6853

Fax

(910) 295-9183

NPI assigned

Sep 15, 2011

Last updated

Jul 26, 2013By the provider in NPPES

Sex

Male

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

State licenses

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

{
    "created_epoch": "1316044800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1374796800000",
    "number": "1982986840",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "284 EXECUTIVE PARK DR",
            "address_2": "SUITE 100",
            "city": "CONCORD",
            "state": "NC",
            "postal_code": "280251894",
            "telephone_number": "704-939-1118",
            "fax_number": "704-939-1173"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "205 MEMORIAL DRIVE",
            "city": "PINEHURST",
            "state": "NC",
            "postal_code": "283708712",
            "telephone_number": "910-295-6853",
            "fax_number": "910-295-9183"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAULK",
        "first_name": "ROLAND",
        "middle_name": "JIMMY",
        "credential": "M.A.,CCC,LPC,LCASA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-09-15",
        "last_updated": "2013-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NC",
            "license": "2836-A",
            "primary": false
        },
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "NC",
            "license": "8955",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• William Ward Patrick, M.D.
• F M Simmons Patterson Jr., MD
• Imani Patterson, BT
• Jerri P Patterson, APRN,BC
• Samantha D Patterson, OTR/L
• Caleb Dale Pearce, M.D.
• Timothy Pearson, M.D.
• Emily Katherine Pellegrini, NP (AGPCNP)
• Alexis Pelzel
• Jessica Peoples

• Counselor in Pinehurst, NC
• Providers in Pinehurst, NC by specialty
• Counselor in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2013; 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.