MR. JERRY FATICA LPA
NPI 1598741035
Psychologist in Jacksonville, NC

Active since December 16, 2005
1703 COUNTRY CLUB ROAD, SUITE 204, JACKSONVILLE, NC 28546(910) 347-3010(910) 347-3201 Get Directions Write a Review

NPPES record last updated: May 8, 2008. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Mr. Jerry Fatica Lpa NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MR. JERRY FATICA LPA (NPI 1598741035) is an individual psychologist in Jacksonville, North Carolina, licensed in North Carolina (1096) and active in the NPI registry since December 2005.

NPPES Registry Identity

NPI1598741035
Entity TypeIndividualMale
Primary Taxonomy103T00000X
Provider Legal NameMR. JERRY FATICACredential: LPA
Location Address1703 COUNTRY CLUB ROAD, SUITE 204Jacksonville, NC 28546
Mailing Address1703 Country Club Road, Suite 204Jacksonville, NC 28546 · (910) 347-3010 · Fax (910) 347-3201
Fax(910) 347-3201
Sole ProprietorNo
Enumeration DateDecember 16, 2005
Last NPPES UpdateMay 8, 2008
NPI 1598741035 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyPsychologistBehavioral Health & Social Service Providers
Taxonomy Code103T00000X
License Licensed in NC · 1096
Definition
A psychologist is an individual who is licensed to practice psychology which is defined as the observation, description, evaluation, interpretation, and modification of human behavior by the application of psychological principles, methods, and procedures, for the purpose of preventing or eliminating symptomatic, maladaptive, or undesired behavior and of enhancing interpersonal relationships, work and life adjustment, personal effectiveness, behavioral health, and mental health. The practice of psychology includes, but is not limited to, psychological testing and the evaluation or assessment of personal characteristics, such as intelligence, personality, abilities, interests, aptitudes, and neuropsychological functioning; counseling, psychoanalysis, psychotherapy, hypnosis, biofeedback, and behavior analysis and therapy; diagnosis and treatment of mental and emotional disorder or disability, alcoholism and substance abuse, disorders of habit or conduct, as well as of the psychological aspects of physical illness, accident, injury, or disability; and psycheducational evaluation, therapy, remediation, and consultation. Psychological services may be rendered to individuals, families, groups and the public.
1703 COUNTRY CLUB ROAD, Jacksonville, NC 28546

Other Identifiers 2

Other141GPNC · Bc/bs
Medicaid6107096NC

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Social Worker
1703 COUNTRY CLUB ROAD, SUITE 204
JACKSONVILLE, NC 28546
Psychologist
1703 COUNTRY CLUB ROAD, SUITE 204
JACKSONVILLE, NC 28546

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Jerry Fatica's NPI number?

The NPI number for Jerry Fatica is 1598741035. It was assigned to this individual provider in the NPPES registry on December 16, 2005.

Where is Jerry Fatica located?

Jerry Fatica practices at 1703 Country Club Road Suite 204, Jacksonville, NC 28546. The listed phone number is (910) 347-3010.

What is Jerry Fatica's specialty?

The primary specialty registered for this NPI is Psychologist with taxonomy code 103T00000X.

When was this NPI record last updated?

The NPPES record for Jerry Fatica was last updated on May 8, 2008. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.