Healthcare Provider Details

I. General information

NPI: 1871682054
Provider Name (Legal Business Name): JANE CHERRY MEADS MS LPC CCAS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/12/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

620 LYNNDALE CT SUITE C
GREENVILLE NC
27858
US

IV. Provider business mailing address

620 LYNNDALE CT SUITE C
GREENVILLE NC
27858
US

V. Phone/Fax

Practice location:
  • Phone: 252-752-8602
  • Fax: 252-752-8103
Mailing address:
  • Phone: 252-752-8602
  • Fax: 252-752-8103

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number747
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number3962
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: