Active NPI
Adam N. Koontz
- Professional Counselor
- Mocksville, NC
National Provider Identifier
1740375625
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 5477
- Practice address
- 119 W Depot St
Mocksville, NC 27028-2327 - Phone
- (336) 751-5636
- NPI assigned
- Oct 4, 2006
- 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 | 5477 | NC | Primary |
Addresses
Primary practice location
119 W Depot St
Mocksville, NC 27028-2327
Mailing address
194 Devonshire Dr
Lexington, NC 27295-7407
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 |
|---|---|---|---|
| 5477 | NC | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159920000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1740375625",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "194 DEVONSHIRE DR",
"city": "LEXINGTON",
"state": "NC",
"postal_code": "272957407"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "119 W DEPOT ST",
"city": "MOCKSVILLE",
"state": "NC",
"postal_code": "270282327",
"telephone_number": "336-751-5636"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KOONTZ",
"first_name": "ADAM",
"middle_name": "N.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-10-04",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "NC",
"license": "5477",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mocksville, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.