Jack Paul Meza Leon

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

LCAS-25285 Issued in NC

Practice address

421 Fayetteville St Ste 1100
Raleigh, NC 27601-3000

Phone

(877) 418-2978

Fax

(866) 500-2186

NPI assigned

Sep 16, 2020

Last updated

Oct 25, 2021By 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)

Not enrolled

State licenses

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

{
    "created_epoch": "1600214400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635120000000",
    "number": "1801402847",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "421 FAYETTEVILLE ST STE 1100",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276013000",
            "telephone_number": "877-418-2978",
            "fax_number": "866-500-2186"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "421 FAYETTEVILLE ST STE 1100",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276013000",
            "telephone_number": "877-418-2978",
            "fax_number": "866-500-2186"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEZA LEON",
        "first_name": "JACK",
        "middle_name": "PAUL",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-09-16",
        "last_updated": "2021-10-25",
        "certification_date": "2021-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "NC",
            "license": null,
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NC",
            "license": "LCAS-25285",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Karen Meyers, MD
• Kaylee Meyers, LCSW
• Michael R Meyers
• Bailey Meyne, LCSWA, J.D., LMSW
• Daniel Francis Meyring, PA-C
• Mga Home Healthcare Fayetteville, LLC (MGA Homecare)
• MH Nursing Service, Inc.
• Patricia Mial-Mosley
• Veronica Yvonne Mial, MSW
• Michael a Derose DDS PA

• Addiction (Substance Use Disorder) Counselor in Raleigh, NC
• Providers in Raleigh, NC by specialty
• Addiction (Substance Use Disorder) Counselor in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2021; 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.