Active NPI
Wendy Marie Jublou, LCASA, LPCA
- Professional Counselor
- Greenville, NC
National Provider Identifier
1063928737
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- A12896
- Practice address
- 223 Commerce St Ste B
Greenville, NC 27858-5032 - Phone
- (252) 758-8636
- NPI assigned
- Dec 18, 2017
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 22870 | NC | |
| Professional Counselor | 101YP2500X | A12896 | NC | Primary |
Addresses
Primary practice location
223 Commerce St Ste B
Greenville, NC 27858-5032
Mailing address
740 Greenville Blvd SE, Ste 400-164
Greenville, NC 27858
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A12896 | NC | MD | Professional Counselor |
| 22870 | NC | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| The Kohler Group, PLLC | Professional | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1513555200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1513555200000",
"number": "1063928737",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "740 GREENVILLE BLVD SE, STE 400-164",
"city": "GREENVILLE",
"state": "NC",
"postal_code": "27858"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "223 COMMERCE ST STE B",
"city": "GREENVILLE",
"state": "NC",
"postal_code": "278585032",
"telephone_number": "252-758-8636"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JUBLOU",
"first_name": "WENDY",
"middle_name": "MARIE",
"credential": "LCASA, LPCA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2017-12-18",
"last_updated": "2017-12-18",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "NC",
"license": "22870",
"primary": false
},
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "NC",
"license": "A12896",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Greenville, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.