Joseph J Fennell II, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

APC001843 Issued in GA

Practice address

19 Church St
Statesboro, GA 30458-5385

Phone

(912) 489-7590

Fax

(912) 489-3877

NPI assigned

Dec 26, 2009

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in GA

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.

• Pawsitive Counseling Center PC

  • Professional Counselor
  • Fremont, MI
  • NPI 1447885447
  NPD (past)

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

{
    "created_epoch": "1261785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1371600000000",
    "number": "1225368152",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19 CHURCH ST",
            "city": "STATESBORO",
            "state": "GA",
            "postal_code": "304585385",
            "telephone_number": "912-489-7590",
            "fax_number": "912-489-3877"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19 CHURCH ST",
            "city": "STATESBORO",
            "state": "GA",
            "postal_code": "304585385",
            "telephone_number": "912-489-7590",
            "fax_number": "912-489-3877"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FENNELL",
        "first_name": "JOSEPH",
        "middle_name": "J",
        "name_prefix": "Mr.",
        "name_suffix": "II",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-12-26",
        "last_updated": "2013-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "GA",
            "license": "APC001843",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLCARE",
            "identifier": "690639",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIGROUP",
            "identifier": "01422484",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Family Podiatry Center PC
• Family Practice Dental Care of Statesboro
• Daniel M Feldman, M.D.
• Gregory Shawn Felzien, M.D.
• Hannah Rae Fennell, RBT
• Becky Alli Fields
• Madison Leigh Fields, LPC
• Asia Victoria Finley
• Williams C Finley Jr., DMD
• Stephen R. Fishack, M.S.W.

• Professional Counselor in Statesboro, GA
• Providers in Statesboro, GA by specialty
• Professional Counselor in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2013; 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.