Jacqueline Monique Parks Leach

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

A14757 Issued in NC

Practice address

419 S York St
Gastonia, NC 28052-4035

Phone

(704) 865-8722

NPI assigned

Apr 12, 2019

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Mental Health Counselor

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Carolinas Physicians Network IncGroup PAC ID 3375449655, 2,324 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Carolinas Physicians Network Inc

  • Orthopaedic Surgery Physician
  • Charlotte, NC
  • NPI 1437607686
  Medicare reassignment Care Compare group NPD
• Liberation Counseling Services PLLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Gastonia, NC
  • NPI 1164118543
  NPD Authorized official
• Carolinas Physicians Network Inc

  • Endocrinology, Diabetes & Metabolism Physician
  • Charlotte, NC
  • NPI 1437038544
  NPD
• Carolinas Physicians Network Inc

  • Registered Dietitian
  • Huntersville, NC
  • NPI 1518405257
  NPD
• Healing and Hope Counseling Center, PLLC

  • Professional Counselor
  • Gastonia, NC
  • NPI 1275848517
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1555027200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1569801600000",
    "number": "1558824888",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "314 DAVIS RD # 2",
            "city": "SHELBY",
            "state": "NC",
            "postal_code": "281528737",
            "telephone_number": "704-418-1632"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "419 S YORK ST",
            "city": "GASTONIA",
            "state": "NC",
            "postal_code": "280524035",
            "telephone_number": "704-865-8722"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARKS LEACH",
        "first_name": "JACQUELINE",
        "middle_name": "MONIQUE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-04-12",
        "last_updated": "2019-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NC",
            "license": "A14757",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Asia D Parker
• James Maxwell Parker, CRNA
• Jennifer Barnhardt Parker, MSW, LCSW
• Phagan Marnei' Parker, NCC, LCMHC, LCASA
• Sonia Teresa Parker
• Shantia Parks, LCSW
• Toi Nicol Parks, LCSWA
• Reggie D Parlier, MD
• Meghan Parmenter
• Stephanie Parmlee

• Professional Counselor in Gastonia, NC
• Providers in Gastonia, NC by specialty
• Professional Counselor in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2019; 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.

Verify at the official NPI Registry.