Individual provider Active NPI

Stefanie Johnson Kincaid, M.ED, NCC, LPCA

  • Mental Health Counselor
  • Apex, NC
National Provider Identifier
1780136341
Registry record updated Oct 31, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
A12410 Issued in NC
Practice address
800 W Williams St
Apex, NC 27502-5203
Phone
(919) 335-3105
NPI assigned
Oct 31, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 31, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X A12410 NC Primary
School Counselor 101YS0200X NC

Addresses

Primary practice location

800 W Williams St
Apex, NC 27502-5203

Mailing address

105 Messer Dr
Siler City, NC 27344-1431
Phone (919) 618-0446

Other names 1

  • Ms. Stefanie Rae Johnson Former name

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
Credentials
Master of Education

State licenses

LicenseStateTypeSpecialty
A12410NCMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1477872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1477872000000",
    "number": "1780136341",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 MESSER DR",
            "city": "SILER CITY",
            "state": "NC",
            "postal_code": "273441431",
            "telephone_number": "919-618-0446"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 W WILLIAMS ST",
            "city": "APEX",
            "state": "NC",
            "postal_code": "275025203",
            "telephone_number": "919-335-3105"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KINCAID",
        "first_name": "STEFANIE",
        "middle_name": "JOHNSON",
        "name_prefix": "Mrs.",
        "credential": "M.ED, NCC, LPCA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-10-31",
        "last_updated": "2016-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NC",
            "license": "A12410",
            "primary": true
        },
        {
            "code": "101YS0200X",
            "taxonomy_group": "",
            "desc": "Counselor, School",
            "state": "NC",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "STEFANIE",
            "last_name": "JOHNSON",
            "middle_name": "RAE",
            "prefix": "MS.",
            "credential": "M.ED, NCC, LPCA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Apex, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2016; 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.