Funderburg, Jamarr J
Funderburg, Jamarr J is an sole proprietor health care provider with primary practice located at 1905 J N Pease Pl Ste 202 , Charlotte NC 28262-4539. He recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), Behavioral Health & Social Service Providers / Clinical. Behavioral Health & Social Service Providers / Clinical is his primary health care specialty. Funderburg, Jamarr J can be contacted via phone (704) 771-4633.Contact Information
Primary practice address
1905 J N Pease Pl Ste 202
Charlotte NC 28262-4539
Phone: (704) 771-4633
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) | 101YA0400X | 1184 | North Carolina |
| Behavioral Health & Social Service Providers / Clinical | 1041C0700X | C005599 | North Carolina |
Profile Details
| NPI number | 1871632430 |
|---|---|
| LBN Legal business name | Funderburg, Jamarr J |
| Credentials | LCSW, LCAS, CCS |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Feb 6th, 2007 |
| Last updated | Oct 24th, 2018 - about 8 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1871632430 | NPPES |
| North Carolina | Other | 1184 | LCAS |
| North Carolina | Other | C005599 | LCAS |
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