Active NPI
Jarrell Stephen McQueen, MSW, LCAS-A
- Addiction (Substance Use Disorder) Counselor
- Wilmington, NC
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction (Substance Use Disorder) Counselor
- License
- LCAS-27427
- Practice address
- 917 N 4TH St
Wilmington, NC 28401-3450 - Phone
- (910) 202-8656
- Fax
- (910) 202-8680
- NPI assigned
- Aug 19, 2021
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | LCAS-27427 | NC | Primary |
Addresses
Primary practice location
917 N 4TH St
Wilmington, NC 28401-3450
Mailing address
925 N 4TH St
Wilmington, NC 28401-3450
Phone (910) 202-8655
Other practice location 1
925 N 4th St
Wilmington, NC 28401-3450
Phone (910) 343-0270
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NC
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Social Worker
- Education
- Other, 2021
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
925 N 4TH St
Wilmington, NC 28401-3450
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LCAS-27427 | NC | MD | Addiction (Substance Use Disorder) Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| New Hanover Community Health Center Incorporated | Current | Accepting new patients | |
| New Hanover Community Health Center Incorporated | Current | Accepting new patients |
Locations
925 N 4th St
Wilmington, NC 28401
Phone (910) 254-4690
240 Calhoun Dr
Wilmington, NC 28412
Phone (910) 202-8656
917 N 4th St
Wilmington, NC 28401
Phone (910) 202-8656
Organizations & group practices 2
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.
-
- Federally Qualified Health Center (FQHC)
- Wilmington, NC
- NPI 1912954090
-
- Federally Qualified Health Center (FQHC)
- Wilmington, NC
- NPI 1457512691
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1629331200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1780963200000",
"number": "1457027484",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "925 N 4TH ST",
"city": "WILMINGTON",
"state": "NC",
"postal_code": "284013450",
"telephone_number": "910-202-8655",
"fax_number": "910-251-1540"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "917 N 4TH ST",
"city": "WILMINGTON",
"state": "NC",
"postal_code": "284013450",
"telephone_number": "910-202-8656",
"fax_number": "910-202-8680"
}
],
"practiceLocations": [
{
"address_1": "925 N 4th St",
"address_purpose": "LOCATION",
"city": "Wilmington",
"state": "NC",
"postal_code": "284013450",
"country_code": "US",
"telephone_number": "910-343-0270",
"fax_number": "910-251-1540",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MCQUEEN",
"first_name": "JARRELL",
"middle_name": "STEPHEN",
"credential": "MSW, LCAS-A",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2021-08-19",
"last_updated": "2026-06-09",
"certification_date": "2026-06-09",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "NC",
"license": "LCAS-27427",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Wilmington, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2026; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.