JACK L MCCONNELL (NPI# 1780888024) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1780888024 |
| Entity Type | Individual |
| Full Name | JACK L MCCONNELL |
| Credential | LCAS |
| Practice Address |
327 1st Ave Nw Hickory NC 28601-6122 |
| Practice Telephone | 8286955900 |
| Practice Fax Number | 8286954256 |
| Mailing Telephone | 8286955900 |
| Mailing Fax Number | 8286954256 |
| Enumeration Date | 2007-06-12 |
| Last Update Date | 2015-08-31 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
1185 | NC | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NC | 1780888024 | 05 |
| Street Address |
327 1ST AVE NW |
| City | HICKORY |
| State | NC |
| Zip Code | 28601-6122 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912907361 | Gary Wayne Poston | Physician Assistant | 327 1st Ave Nw, Hickory, NC 28601-6122 | 2005-07-28 |
| 1619578010 | Lisa M Lacy | Social Worker | 327 1st Ave Nw, Hickory, NC 28601-6122 | 2020-11-03 |
| 1235780487 | Rachel Jordan Polanski | Physician Assistant | 327 1st Ave Nw, Hickory, NC 28601-6122 | 2019-09-27 |
| 1235609264 | Rikki L Rogers | Social Worker | 327 1st Ave Nw, Hickory, NC 28601-6122 | 2018-12-03 |
| 1578043477 | October Evans Makabin | Social Worker | 327 1st Ave Nw, Hickory, NC 28601-6122 | 2018-08-20 |
| 1174026710 | Crystal N Burrell | Counselor | 327 1st Ave Nw, Hickory, NC 28601-6122 | 2018-03-09 |
| 1871008649 | Dawn Lorraine Mcneely | Nurse Practitioner | 327 1st Ave Nw, Hickory, NC 28601-6122 | 2017-12-02 |
| 1538511225 | Francis Sterling Penland | Nurse Practitioner | 327 1st Ave Nw, Hickory, NC 28601 | 2016-07-06 |
| 1487004545 | Tiffany Nicole Randazza | Counselor | 327 1st Ave Nw, Hickory, NC 28601-6122 | 2016-06-20 |
| 1316396260 | Jan E Carroll | Counselor | 327 1st Ave Nw, Hickory, NC 28601-6122 | 2016-06-10 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417555236 | Mathew Ryan Dunn | Specialist/Technologist | 755 5th St Ne, Hickory, NC 28601 | 2020-10-14 |
| 1669086757 | Alex Neil Hines | Massage Therapist | 2759 North Center Street, Hickory, NC 28601 | 2020-09-04 |
| 1306327515 | Natasha Anderson | Nurse Practitioner | 2830 16th St Ne Apt 94, Hickory, NC 28601 | 2018-08-25 |
| 1902382120 | Danielle Marie Cisney | Counselor | 1219 10th Street Blvd Nw Apt F, Hickory, NC 28601 | 2018-07-11 |
| 1295243681 | Maggie Isabelle Mccarrick | Specialist/Technologist | 2225 6th St Nw, Hickory, NC 28601 | 2018-01-19 |
| 1487165395 | Healthstat Onsite Clinic Hsm Metal | Preventive Medicine | 180 Mcdonald Parkway Sw, Hickory, NC 28601 | 2017-10-18 |
| 1407249691 | Alexcia Dawn Pennell | Registered Nurse | 1501 Tate Blvd Sw, Suite 201, Hickory, NC 28601 | 2015-03-11 |
| 1134527484 | Pamilla Griffin Yount | Specialist | 825 3rd Ave. Nw, Hickory, NC 28601 | 2014-12-18 |
| 1831593615 | Josephine Lovelace Polhemus | Pharmacist | 12th Avenue Ne, Hickory, NC 28601 | 2014-10-22 |
| 1275957128 | Amy Lor | Acupuncturist | 46 Cloninger Mill Rd Ne Ste E, Hickory, NC 28601 | 2014-02-13 |
| Find all providers in zip 28601 | ||||
| Taxonomy Code | 101YA0400X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Addiction (Substance Use Disorder) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225671571 | Katrina Marie Belmont | Counselor | 2247 S Center St, Hickory, NC 28602-5319 | 2019-10-18 |
| 1891253266 | Rebecca Joy Johnson-das | Counselor | 5577 Brookwood Ln, Hickory, NC 28602-5507 | 2019-03-05 |
| 1467948521 | Genisys Complete Recovery, LLC | Counselor | 10 3rd Ave Ne Ste 400, Hickory, NC 28601-5044 | 2018-07-02 |
| 1689197923 | Kristen R Seese | Counselor | 423 7th Ave Sw, Hickory, NC 28602-3237 | 2017-07-19 |
| 1609313287 | Shameka Owens | Counselor | 2705 N Center St, Apt 9, Hickory, NC 28601-1353 | 2017-01-20 |
| 1447666953 | Rosanne Rzasa | Counselor | 1170a Fairgrove Church Road, Hickory, NC 28602 | 2014-07-03 |
| 1952743668 | Corey John Richardson | Counselor | 211a S Nc 127 Hwy, Hickory, NC 28602-3541 | 2013-07-23 |
| 1609149590 | Heather Ann Sain | Counselor | 336 Lenoir Rhyne Blvd Se Ste 1, Hickory, NC 28602-3878 | 2012-02-22 |
| 1730354341 | Ed L Mccrary | Counselor | 323 2nd St Nw, Hickory, NC 28601-4904 | 2008-04-24 |
| 1447439310 | Virginia Lee Reid | Counselor | 1206 Fairgrove Church Rd, Hickory, NC 28602-9696 | 2007-10-29 |
| Find all providers in HICKORY | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.