Caitlin Evey Jennings

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

17602 Issued in NC

Practice address

6255 Towncenter Dr Ste 955
Clemmons, NC 27012-9376

Phone

(336) 422-6596

NPI assigned

Jul 20, 2022

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

Medicare fee-for-service enrollment

Enrolled in NC

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Mental Health Specialty Group PA

  • Mental Health Counselor
  • Durham, NC
  • NPI 1801472634
  Medicare reassignment NPD
• Gaston Family Health Services, Inc.

  • Federally Qualified Health Center (FQHC)
  • Mocksville, NC
  • NPI 1699346965
  NPD (past)

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

{
    "created_epoch": "1658275200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747180800000",
    "number": "1104551407",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6255 TOWNCENTER DR STE 955",
            "city": "CLEMMONS",
            "state": "NC",
            "postal_code": "270129376",
            "telephone_number": "336-422-6596"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6255 TOWNCENTER DR STE 955",
            "city": "CLEMMONS",
            "state": "NC",
            "postal_code": "270129376",
            "telephone_number": "336-422-6596"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JENNINGS",
        "first_name": "CAITLIN",
        "middle_name": "EVEY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-07-20",
        "last_updated": "2025-05-14",
        "certification_date": "2025-05-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NC",
            "license": "17602",
            "primary": true
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "SC",
            "license": "10651",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brittany Miles James, NP
• Holly Anne Jamison, FNP-BC
• Kimberly Janvier, DNP, FNP-BC, APRN
• Sandra Lee Jarvis, NP
• Stephanie Marie Jasso
• Kyle Joseph Jensen
• Candice Darcy Johnson-Leonard, ANP-C
• Kimberly D Johnson
• Melissa Ann Johnson, LCSW, LCAS, CCS
• Randy J. Johnson, LCMHC

• Mental Health Counselor in Clemmons, NC
• Providers in Clemmons, NC by specialty
• Mental Health Counselor in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.