Active NPI
Jefferson McCombs, LPC, MED
- Counselor
- Kannapolis, NC
National Provider Identifier
1548209885
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counselor
- License
- 1080
- Practice address
- 608 McCombs Ave
Kannapolis, NC 28083-3605 - Phone
- (704) 933-0007
- Fax
- (704) 933-0300
- NPI assigned
- Jun 5, 2006
- Last updated
- May 3, 2011
- 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 |
|---|---|---|---|---|
| Counselor | 101Y00000X | 1080 | NC | Primary |
Addresses
Primary practice location
608 McCombs Ave
Kannapolis, NC 28083-3605
Mailing address
PO Box 8381
Kannapolis, NC 28081-1804
Phone (704) 933-0007
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 56448 | Other | NC | BCBS PROVIDER ID |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Dec 13, 2024 through Dec 13, 2026
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Master of Education
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1080 | NC | MD | Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| McCombs Counseling & Consulting, Inc | Counselor | Current | Accepting new patients |
Locations
608 McCombs Ave
Kannapolis, NC 28083
Phone (704) 933-0007
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Counselor
- Kannapolis, NC
- NPI 1053378885
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1149465600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1304380800000",
"number": "1548209885",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 8381",
"city": "KANNAPOLIS",
"state": "NC",
"postal_code": "280811804",
"telephone_number": "704-933-0007",
"fax_number": "704-933-0300"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "608 MCCOMBS AVE",
"city": "KANNAPOLIS",
"state": "NC",
"postal_code": "280833605",
"telephone_number": "704-933-0007",
"fax_number": "704-933-0300"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCCOMBS",
"first_name": "JEFFERSON",
"credential": "LPC, MED",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-06-05",
"last_updated": "2011-05-03",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": "NC",
"license": "1080",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS PROVIDER ID",
"identifier": "56448",
"state": "NC"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Kannapolis, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.