MEDICARE: JESSE JOEL PRITCHARD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	P023342	NC

General Provider Information

NPI Number	:	1720945629
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JESSE JOEL PRITCHARD

Provider Business Mailing Address
First Line	:	11703 ROCKCASTLE DR
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28273-3741
Country	:	US
Telephone Number	:	704-443-0144
Fax Number	:

Provider Business Practice Location Address
First Line	:	3046 SENNA DR
Second Line	:
City	:	MATTHEWS
State	:	NC
Zip	:	28105-6726
Country	:	US
Telephone Number	:	704-443-0144
Fax Number	:	704-376-1131

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/05/2026
Last Update Date	:	01/05/2026

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Directions to “ JESSE JOEL PRITCHARD ” Practice Location

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