Jennifer Ann Stulck, LCMHC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

10316 Issued in NC

Practice address

363 Graphite Rd
Old Fort, NC 28762-9455

Phone

(781) 541-0073

NPI assigned

Jun 8, 2022

Last updated

Jun 8, 2022By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1654646400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654646400000",
    "number": "1245969997",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "50 COVINGTON ST",
            "city": "ASHEVILLE",
            "state": "NC",
            "postal_code": "288062626",
            "telephone_number": "781-541-0073"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "363 GRAPHITE RD",
            "city": "OLD FORT",
            "state": "NC",
            "postal_code": "287629455",
            "telephone_number": "781-541-0073"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "50 Covington St",
            "address_purpose": "LOCATION",
            "city": "Asheville",
            "state": "NC",
            "postal_code": "288062626",
            "country_code": "US",
            "telephone_number": "781-541-0073",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STULCK",
        "first_name": "JENNIFER",
        "middle_name": "ANN",
        "credential": "LCMHC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-06-08",
        "last_updated": "2022-06-08",
        "certification_date": "2022-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NC",
            "license": "10316",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Anna Shtymak, PA
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• John Robert Summerour, RPH
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• The McDowell Hospital Inc (Mission Community Medicine Old Fort)
• Jon Charles Tripp, L.P.C.

• Mental Health Counselor in Old Fort, NC
• Providers in Old Fort, NC by specialty
• Mental Health Counselor in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 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.

Verify at the official NPI Registry.