Individual provider Active NPI

Jill M Minogue, LPCC

  • Professional Counselor
  • Fayetteville, NC
National Provider Identifier
1235350323
Registry record updated Apr 7, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
1080 Issued in KY
Practice address
1310 Raeford Rd
2
Fayetteville, NC 28305-5085
Phone
(502) 381-0041
NPI assigned
May 2, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 7, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 1080 KY Primary

Addresses

Primary practice location

1310 Raeford Rd
2
Fayetteville, NC 28305-5085

Mailing address

1000 Little Gem Dr
106
Fayetteville, NC 28314-2584
Phone (502) 381-0041

Other identifiers 1

IdentifierTypeStateIssuer
7100284760MedicaidKY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
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

Enrollment IDStateProvider typePAC IDDetails
I20240205000709 SC Practitioner - Mental Health Counselor 3971946245 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

327 Dunlin PL
Conway, SC 29526-1611
Phone (502) 381-0041

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1080KYMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Rediscover Wellness, LLC Professional CurrentSince Jan 22, 2024 Accepting new patients
Teladoc Health Medical Group, P.a. Professional Current Accepting new patients
Verna Dority, MSW, CCSW, Inc PastSince Feb 15, 2020 Accepting new patients

Interoperability endpoints

  • Direct secure messaging: jillminogue@tdh.allscriptsdirect.net

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1178064000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1459987200000",
    "number": "1235350323",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 LITTLE GEM DR",
            "address_2": "106",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283142584",
            "telephone_number": "502-381-0041"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1310 RAEFORD RD",
            "address_2": "2",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283055085",
            "telephone_number": "502-381-0041"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MINOGUE",
        "first_name": "JILL",
        "middle_name": "M",
        "credential": "LPCC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-02",
        "last_updated": "2016-04-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "KY",
            "license": "1080",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100284760",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fayetteville, NC

Sources for this page

Verify at the official NPI Registry.