TADANA PRAYER JENNETTE NPI 1083082689

NPI Information

NPI: 1083082689
Provider Name: TADANA PRAYER JENNETTE
Classification: Counselor - 101YP2500X
Entity Type: Individual

Specialization: Professional

Address:
620 LYNNDALE CT STE C
GREENVILLE, NC
ZIP 27858
Phone: (252) 814-5564
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Tadana Prayer Jennette is a professional counselor in Greenville, NC. Tadana Prayer Jennette NPI is 1083082689. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

620 LYNNDALE CT STE C
GREENVILLE, NC
ZIP 27858-462
Phone: (252) 814-5564

The enumeration date for this NPI number is 9/14/2015 and was last updated on 10/15/2021.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	101YA0400X	Counselor	Addiction (Substance Use Disorder)	3567	NORTH CAROLINA	No
2	101YP2500X	Counselor	Professional	A12098	NORTH CAROLINA	No
3	101YP2500X	Counselor	Professional	12098	NORTH CAROLINA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	3567	OTHER	NORTH CAROLINA	LICENSED CLINICAL ADDICTIONS SPECIALIST
2	12098	OTHER	NORTH CAROLINA	LICENSED CLINICAL MENTAL HEALTH COUNSELOR

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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