Active NPI
Kerry W. Wicks, MS, LAC, LPCC
- Professional Counselor
- Jamestown, ND
National Provider Identifier
1255429643
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- Practice address
- 3952 Highway 281 SE
Jamestown, ND 58401-9408 - Phone
- (701) 252-8939
- NPI assigned
- Oct 11, 2006
- Sex
- Male
- Sole proprietor
- Yes
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 | ND | Primary |
Addresses
Primary practice location
3952 Highway 281 SE
Jamestown, ND 58401-9408
Mailing address
3952 Highway 281 SE
Jamestown, ND 58401-9408
Phone (701) 252-8939
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 9202 | Other | ND | BCBS IDENTIFIER |
| WIC17788 | Other | ND | BCBS IDENTIFIER |
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
- Credentials
- Master of Science
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1160524800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1255429643",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3952 HIGHWAY 281 SE",
"city": "JAMESTOWN",
"state": "ND",
"postal_code": "584019408",
"telephone_number": "701-252-8939"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3952 HIGHWAY 281 SE",
"city": "JAMESTOWN",
"state": "ND",
"postal_code": "584019408",
"telephone_number": "701-252-8939"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WICKS",
"first_name": "KERRY",
"middle_name": "W.",
"name_prefix": "Mr.",
"credential": "MS, LAC, LPCC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-10-11",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "ND",
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS IDENTIFIER",
"identifier": "9202",
"state": "ND"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS IDENTIFIER",
"identifier": "WIC17788",
"state": "ND"
}
],
"endpoints": [],
"other_names": []
}Other providers in Jamestown, ND
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.