Jennifer M. Deacon, PSYCH. ASSOCIATE

Primary specialty

Intellectual & Developmental Disabilities PsychologistTaxonomy code 103TM1800X

License

1982 Issued in NC

Practice address

512 Riverside Dr
Morganton, NC 28655-3727

Phone

(828) 403-3353

NPI assigned

Jan 8, 2008

Last updated

Jul 5, 2021By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in NC

Enrollment records 1

Specialty

Clinical Psychologist

Education

Other, 1995

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1199750400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1625443200000",
    "number": "1063697118",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "512 RIVERSIDE DR",
            "city": "MORGANTON",
            "state": "NC",
            "postal_code": "286553727",
            "telephone_number": "828-433-8084"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "512 RIVERSIDE DR",
            "city": "MORGANTON",
            "state": "NC",
            "postal_code": "286553727",
            "telephone_number": "828-403-3353"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEACON",
        "first_name": "JENNIFER",
        "middle_name": "M.",
        "name_prefix": "Mrs.",
        "credential": "PSYCH. ASSOCIATE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-01-08",
        "last_updated": "2021-07-05",
        "certification_date": "2021-07-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TM1800X",
            "taxonomy_group": "",
            "desc": "Psychologist, Intellectual & Developmental Disabilities",
            "state": "NC",
            "license": "1982",
            "primary": true
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "NC",
            "license": "1-12-12257",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6107547",
            "state": "NC"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "deaconbehavioralservices@gmail.com",
            "affiliation": "N",
            "address_1": "512 Riverside Dr",
            "city": "Morganton",
            "state": "NC",
            "country_code": "US",
            "postal_code": "286553727",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• James F Davidson IV, M.D.
• Deborah Hogan Davis, M.D.
• Sally Day
• Days of Comfort F C H
• Fernando A. De la Serna, MD
• Joseph Ridgway Deacon III, PH.D.
• Annie Deal, FNP-C
• Robert Jason Deal, D.M.D.
• Darcy L Dean, RDN, LDN
• Barbara Jane Deaton, APRN-BC

• Intellectual & Developmental Disabilities Psychologist in Morganton, NC
• Providers in Morganton, NC by specialty
• Intellectual & Developmental Disabilities Psychologist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 5, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.