Active NPI
Christian Richard Immel, LPCA, NCC
- Professional Counselor
- North Wilkesboro, NC
National Provider Identifier
1154839306
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- A13517
- Practice address
- 1400 Willow LN
North Wilkesboro, NC 28659-3551 - Phone
- (338) 844-4567
- NPI assigned
- Jan 22, 2018
- Sex
- Male
- 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 | A13517 | NC | Primary |
Addresses
Primary practice location
1400 Willow LN
North Wilkesboro, NC 28659-3551
Mailing address
1400 Willow LN
North Wilkesboro, NC 28659-3551
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 |
|---|---|---|---|
| A13517 | NC | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1516579200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1560988800000",
"number": "1154839306",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1400 WILLOW LN",
"city": "NORTH WILKESBORO",
"state": "NC",
"postal_code": "286593551"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1400 WILLOW LN",
"city": "NORTH WILKESBORO",
"state": "NC",
"postal_code": "286593551",
"telephone_number": "338-844-4567"
}
],
"practiceLocations": [],
"basic": {
"last_name": "IMMEL",
"first_name": "CHRISTIAN",
"middle_name": "RICHARD",
"name_prefix": "Mr.",
"credential": "LPCA, NCC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2018-01-22",
"last_updated": "2019-06-20",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "NC",
"license": "A13517",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in North Wilkesboro, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.