Active NPI
Susan McKendry, MA
- Professional Counselor
- Asheboro, NC
National Provider Identifier
1104117308
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 937
- Practice address
- 1205 N Fayetteville St
Asheboro, NC 27203-4595 - Phone
- (336) 629-4471
- Fax
- (336) 629-5805
- NPI assigned
- Apr 22, 2011
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 937 | NC | Primary |
Addresses
Primary practice location
1205 N Fayetteville St
Asheboro, NC 27203-4595
Mailing address
1205 N Fayetteville St
Asheboro, NC 27203-4595
Phone (336) 629-4471
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 6111817 | Medicaid | NC |
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
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 937 | NC | MD | Marriage & Family Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Wendy L. Davis | 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.
-
- Counselor
- Asheboro, NC
- NPI 1437351673
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1303430400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1371168000000",
"number": "1104117308",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1205 N FAYETTEVILLE ST",
"city": "ASHEBORO",
"state": "NC",
"postal_code": "272034595",
"telephone_number": "336-629-4471",
"fax_number": "336-629-5805"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1205 N FAYETTEVILLE ST",
"city": "ASHEBORO",
"state": "NC",
"postal_code": "272034595",
"telephone_number": "336-629-4471",
"fax_number": "336-629-5805"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCKENDRY",
"first_name": "SUSAN",
"credential": "MA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-04-22",
"last_updated": "2013-06-14",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "NC",
"license": "937",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "6111817",
"state": "NC"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Asheboro, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.