Jon Charles Tripp, L.P.C.
Individual provider Active NPI Counselor · Old Fort, NC
NPI 1174701288 · NPPES record last updated Jan 31, 2008
Key facts
- NPI
- 1174701288
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Counselor 101Y00000X
- License
- 4159 (NC)
- Practice address
- 90 Mackey Farm Dr
Old Fort, NC 28762 - Phone
- (828) 652-1318
- NPI assigned
- Jan 31, 2008
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4159 | NC | MD | Dentist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | 4159 | NC | Yes |
Addresses
Primary practice location
90 Mackey Farm Dr
Old Fort, NC 28762
Mailing address
90 Mackey Farm Dr
Old Fort, NC 28762-8797
Other providers in Old Fort, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 31, 2008. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.