Provider Demographics
NPI:1952574865
Name:POE, JAMES R (LPC)
Entity type:Individual
Prefix:MR
First Name:JAMES
Middle Name:R
Last Name:POE
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
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Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:409 JOY CT
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28540-9301
Mailing Address - Country:US
Mailing Address - Phone:910-340-5710
Mailing Address - Fax:
Practice Address - Street 1:200 VALENCIA DR
Practice Address - Street 2:SUITE 123
Practice Address - City:JACKSONVILLE
Practice Address - State:NC
Practice Address - Zip Code:28546-6311
Practice Address - Country:US
Practice Address - Phone:910-340-5710
Practice Address - Fax:910-353-4310
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-11
Last Update Date:2016-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC4148101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
12554537OtherCAQC