Active NPI
Kelleyanne Helene Lonergan
- Addiction (Substance Use Disorder) Counselor
- Shallotte, NC
National Provider Identifier
1124658778
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction (Substance Use Disorder) Counselor
- Practice address
- 4437 Main St
Shallotte, NC 28470-4451 - Phone
- (910) 617-0222
- NPI assigned
- Jan 23, 2020
- 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 |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | NC | Primary |
Addresses
Primary practice location
4437 Main St
Shallotte, NC 28470-4451
Mailing address
4437 Main St
Shallotte, NC 28470-4451
Phone (910) 617-0222
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1579737600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1656374400000",
"number": "1124658778",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4437 MAIN ST",
"city": "SHALLOTTE",
"state": "NC",
"postal_code": "284704451",
"telephone_number": "910-617-0222"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4437 MAIN ST",
"city": "SHALLOTTE",
"state": "NC",
"postal_code": "284704451",
"telephone_number": "910-617-0222"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LONERGAN",
"first_name": "KELLEYANNE",
"middle_name": "HELENE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-01-23",
"last_updated": "2022-06-28",
"certification_date": "2022-06-28",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "NC",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Shallotte, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.