Active NPI
Kendall Jermaine Garvin, MS LPCA
- Professional Counselor
- Asheboro, NC
National Provider Identifier
1326490772
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- A12548
- Practice address
- 110 W Walker Ave
Asheboro, NC 27203-6760 - Phone
- (336) 633-7000
- Fax
- (336) 625-3817
- NPI assigned
- Jul 11, 2016
- Last updated
- Jul 21, 2022
- 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 | A12548 | NC | Primary |
Addresses
Primary practice location
110 W Walker Ave
Asheboro, NC 27203-6760
Mailing address
284 Executive Park Dr Ste 100
Concord, NC 28025-1833
Phone (704) 939-1100
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 19NKM | Other | NC | BCBS |
| 1326490777 | Medicaid | NC |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A12548 | NC | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1468195200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1658361600000",
"number": "1326490772",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "284 EXECUTIVE PARK DR STE 100",
"city": "CONCORD",
"state": "NC",
"postal_code": "280251833",
"telephone_number": "704-939-1100",
"fax_number": "704-939-1173"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "110 W WALKER AVE",
"city": "ASHEBORO",
"state": "NC",
"postal_code": "272036760",
"telephone_number": "336-633-7000",
"fax_number": "336-625-3817"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GARVIN",
"first_name": "KENDALL",
"middle_name": "JERMAINE",
"name_prefix": "Mr.",
"credential": "MS LPCA",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2016-07-11",
"last_updated": "2022-07-21",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "NC",
"license": "A12548",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "19NKM",
"state": "NC"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1326490777",
"state": "NC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Asheboro, NC
- Evelyn Isel Garcia Lopez, M.S, CF-SLP
- Jasmin Garcia-Solis, LCSWA
- Richard Jahn Gardner, RN
- Kendall Kay Garing, M.D.
- Sara Evelyn Garner, BT
- Gary Cameron, DDS, P.C. (Asheboro Dental Care)
- Gaston Family Health Services, Inc (Kintegra at Balfour Elementary)
- Gaston Family Health Services, Inc (Kintegra at Charles W. McCrary Elementary)
- Gaston Family Health Services, Inc (Kintegra at Donna Lee Loflin Elementary)
- Gaston Family Health Services, Inc (Kintegra at Lindley Park Elementary)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 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.