Provider Demographics
NPI:1215799457
Name:SUMTER, JAMES (PEER SUPPORT SPEC)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:
Last Name:SUMTER
Suffix:
Gender:M
Credentials:PEER SUPPORT SPEC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2428 CONEFLOWER DR
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28213-9284
Mailing Address - Country:US
Mailing Address - Phone:803-849-3277
Mailing Address - Fax:
Practice Address - Street 1:2428 CONEFLOWER DR
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28213-9284
Practice Address - Country:US
Practice Address - Phone:803-849-3277
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-24
Last Update Date:2024-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2022-9628-01175T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist