Active NPI
Jack P. Locicero Sr., LPC
- Professional Counselor
- Winston Salem, NC
National Provider Identifier
1528206786
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 2276
- Practice address
- 5178 Oxford Dr
Winston Salem, NC 27104-2450 - Phone
- (336) 624-6733
- NPI assigned
- Jan 27, 2009
- 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 | 2276 | NC | Primary |
Addresses
Primary practice location
5178 Oxford Dr
Winston Salem, NC 27104-2450
Mailing address
5178 Oxford Dr
Winston Salem, NC 27104-2450
Phone (336) 624-6733
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2276 | NC | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1233014400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1233014400000",
"number": "1528206786",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5178 OXFORD DR",
"city": "WINSTON SALEM",
"state": "NC",
"postal_code": "271042450",
"telephone_number": "336-624-6733"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5178 OXFORD DR",
"city": "WINSTON SALEM",
"state": "NC",
"postal_code": "271042450",
"telephone_number": "336-624-6733"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LOCICERO",
"first_name": "JACK",
"middle_name": "P.",
"name_suffix": "Sr.",
"credential": "LPC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2009-01-27",
"last_updated": "2009-01-27",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "NC",
"license": "2276",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Winston Salem, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.