Active NPI
Kenneth Lee Carrico, Jr. Jr., PH.D.
- Clinical Psychologist
- Morganton, NC
National Provider Identifier
1770697336
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 3289
- Practice address
- 1001 E Union St Ste B
Morganton, NC 28655-2863 - Phone
- (828) 438-6226
- Fax
- (828) 438-6225
- NPI assigned
- Aug 19, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | P00956 | TN | |
| Clinical Psychologist | 103TC0700X | 3289 | NC | Primary |
Addresses
Primary practice location
1001 E Union St Ste B
Morganton, NC 28655-2863
Mailing address
3050 11TH Avenue Dr SE
Hickory, NC 28602-8336
Phone (828) 695-5900
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 6000931 | Medicaid | NC |
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)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| P00956 | TN | MD | Clinical Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Arp/Phoenix of Burke | Past | Accepting new patients |
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 and National Provider Directory roles.
-
- Mental Health Counselor
- Asheville, NC
- NPI 1104848696
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1155945600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183939200000",
"number": "1770697336",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3050 11TH AVENUE DR SE",
"city": "HICKORY",
"state": "NC",
"postal_code": "286028336",
"telephone_number": "828-695-5900",
"fax_number": "828-695-4256"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1001 E UNION ST STE B",
"city": "MORGANTON",
"state": "NC",
"postal_code": "286552863",
"telephone_number": "828-438-6226",
"fax_number": "828-438-6225"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CARRICO, JR.",
"first_name": "KENNETH",
"middle_name": "LEE",
"name_prefix": "Dr.",
"name_suffix": "Jr.",
"credential": "PH.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-19",
"last_updated": "2007-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "TN",
"license": "P00956",
"primary": false
},
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "NC",
"license": "3289",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "6000931",
"state": "NC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Morganton, NC
- Carolina Spine & Neurosurgery Center, PA
- Carolinas Medical Center at Home, LLC
- Carolinas Medical Center at Home, LLC
- Carolinas Physicians Network Inc
- Carolinas Physicians Network Inc
- Laura Rebecca Carson, MSW, LCSW
- Brittany Brown Carswell, PHARMD
- Heather Carswell, OTRL
- Shirley Jean Carswell
- Andrew Carter
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 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.