Provider Demographics
NPI:1871682054
Name:MEADS, JANE CHERRY (MS LPC CCAS)
Entity Type:Individual
Prefix:
First Name:JANE
Middle Name:CHERRY
Last Name:MEADS
Suffix:
Gender:F
Credentials:MS LPC CCAS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:620 LYNNDALE CT
Mailing Address - Street 2:SUITE C
Mailing Address - City:GREENVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27858
Mailing Address - Country:US
Mailing Address - Phone:252-752-8602
Mailing Address - Fax:252-752-8103
Practice Address - Street 1:620 LYNNDALE CT
Practice Address - Street 2:SUITE C
Practice Address - City:GREENVILLE
Practice Address - State:NC
Practice Address - Zip Code:27858
Practice Address - Country:US
Practice Address - Phone:252-752-8602
Practice Address - Fax:252-752-8103
Is Sole Proprietor?:No
Enumeration Date:2006-10-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC747101YA0400X
NC3962101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Not Answered101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC140Y2OtherBCBS
NC6102141Medicaid
NCA8639OtherMEDEOST