John Paul Kretkowski

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

22239 Issued in NC

Practice address

400 Flemington Dr
Lake Waccamaw, NC 28450-1932

Phone

(910) 646-3083

NPI assigned

Dec 18, 2019

Last updated

Oct 5, 2026By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1576627200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1791158400000",
    "number": "1609414754",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2007 RED WOODPECKERS CT",
            "city": "LELAND",
            "state": "NC",
            "postal_code": "284515654"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 FLEMINGTON DR",
            "city": "LAKE WACCAMAW",
            "state": "NC",
            "postal_code": "284501932",
            "telephone_number": "910-646-3083"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRETKOWSKI",
        "first_name": "JOHN PAUL",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-12-18",
        "last_updated": "2026-10-05",
        "certification_date": "2026-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NC",
            "license": "22239",
            "primary": true
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NY",
            "license": "012200",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Haven Ministires, Inc.
• Haven Ministries, Inc.
• Haven Ministries, Inc.
• Teresa B Hopkins, FNP
• Journeys Healthcare
• Lake Pointe Assisted Living, Inc.
• Lake Waccamaw Fire & Rescue Squad
• Lake Waccamaw Primary Care, PLLC
• De'Voncia Lachel Mickins
• New Opportunities of Columbus Co.

• Mental Health Counselor in Lake Waccamaw, NC
• Providers in Lake Waccamaw, NC by specialty
• Mental Health Counselor in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.