Patrick Owen McCloy, LCAS | NPI 1609348663

Key facts

NPI: 1609348663
Entity type: Individual (NPI type 1)
Primary specialty: Addiction (Substance Use Disorder) Counselor 101YA0400X
License: LCAS-22971 (NC)
Practice address: 2915 Dry Ponds Rd
Granite Falls, NC 28630-9652
Phone: (828) 638-1434
NPI assigned: Dec 31, 2018
Sex: Male
Sole proprietor: Yes

Medicare participation

Medicare fee-for-service enrollment: Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD): No

State licenses

License	State	Type	Specialty
LCAS-22971	NC	MD	Addiction (Substance Use Disorder) Counselor

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Addiction (Substance Use Disorder) Counselor Group: 193400000X SINGLE SPECIALTY GROUP	101YA0400X	LCAS-22971	NC	Yes

Addresses

Primary practice location

2915 Dry Ponds Rd
Granite Falls, NC 28630-9652

Mailing address

2915 Dry Ponds Rd
Granite Falls, NC 28630-9652
Phone (828) 638-1434

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Dec 31, 2018.

{
    "created_epoch": "1546214400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1546214400000",
    "number": "1609348663",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2915 DRY PONDS RD",
            "city": "GRANITE FALLS",
            "state": "NC",
            "postal_code": "286309652",
            "telephone_number": "828-638-1434"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2915 DRY PONDS RD",
            "city": "GRANITE FALLS",
            "state": "NC",
            "postal_code": "286309652",
            "telephone_number": "828-638-1434"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCLOY",
        "first_name": "PATRICK",
        "middle_name": "OWEN",
        "credential": "LCAS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-12-31",
        "last_updated": "2018-12-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NC",
            "license": "LCAS-22971",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Granite Falls, NC

All providers in Granite Falls, NC · Addiction (Substance Use Disorder) Counselor in North Carolina

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 31, 2018. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.