Leon Jackson Pernell Sr., LCAS

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

56 Issued in NC

Practice address

804 S Garnett St
Henderson, NC 27536-4571

Phone

(252) 430-8774

Fax

(252) 430-8821

NPI assigned

Oct 1, 2008

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

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": "1222819200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1222819200000",
    "number": "1821249541",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "804 S GARNETT ST",
            "city": "HENDERSON",
            "state": "NC",
            "postal_code": "275364571",
            "telephone_number": "252-430-8774",
            "fax_number": "252-430-8821"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "804 S GARNETT ST",
            "city": "HENDERSON",
            "state": "NC",
            "postal_code": "275364571",
            "telephone_number": "252-430-8774",
            "fax_number": "252-430-8821"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PERNELL",
        "first_name": "LEON",
        "middle_name": "JACKSON",
        "name_prefix": "Mr.",
        "name_suffix": "Sr.",
        "credential": "LCAS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-10-01",
        "last_updated": "2008-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NC",
            "license": "56",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Margaret Jean Peck, D.C.
• Pelican Health Henderson LLC
• David Edward Peltier, D.O.
• Jill Holtzman Perkinson
• Kathryn Elizabeth Perkinson
• Samantha Carole Pernell
• Donna Perry, RN
• James Howard Perry, M.D.
• La'Shanda Michelle Person, LCASA
• Mary Frances Pettway, R.N.

• Addiction (Substance Use Disorder) Counselor in Henderson, NC
• Providers in Henderson, 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 1, 2008; 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.