Active NPI
Regina Lynette McConley, PHD, MPH
- Clinical Psychologist
- Wilmington, NC
National Provider Identifier
1841504388
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 4021
- Practice address
- 5617 Maxwell PL
Wilmington, NC 28409-2966 - Phone
- (910) 742-9243
- Fax
- (888) 746-1787
- NPI assigned
- Jul 26, 2010
- Sex
- Female
- 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 | 4021 | NC | Primary |
| Health Psychologist | 103TH0004X | 4021 | NC |
Addresses
Primary practice location
5617 Maxwell PL
Wilmington, NC 28409-2966
Mailing address
PO Box 16310
Wilmington, NC 28408-6310
Phone (910) 742-9243
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3849920 | Other | NC | CIGNA BEHAVIORAL HEALTH |
| 9179802 | Other | NC | AETNA BEHAVIORAL HEALTH |
| 1674Y | Other | NC | BCBSNC |
| 6001318 | Medicaid | NC | |
| P01143643 | Other | NC | RR MEDICARE |
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 |
|---|---|---|---|
| 4021 | NC | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1280102400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1382572800000",
"number": "1841504388",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 16310",
"city": "WILMINGTON",
"state": "NC",
"postal_code": "284086310",
"telephone_number": "910-742-9243",
"fax_number": "888-746-1787"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5617 MAXWELL PL",
"city": "WILMINGTON",
"state": "NC",
"postal_code": "284092966",
"telephone_number": "910-742-9243",
"fax_number": "888-746-1787"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCCONLEY",
"first_name": "REGINA",
"middle_name": "LYNETTE",
"name_prefix": "Dr.",
"credential": "PHD, MPH",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-07-26",
"last_updated": "2013-10-24",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "NC",
"license": "4021",
"primary": true
},
{
"code": "103TH0004X",
"taxonomy_group": "",
"desc": "Psychologist, Health",
"state": "NC",
"license": "4021",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CIGNA BEHAVIORAL HEALTH",
"identifier": "3849920",
"state": "NC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA BEHAVIORAL HEALTH",
"identifier": "9179802",
"state": "NC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBSNC",
"identifier": "1674Y",
"state": "NC"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "6001318",
"state": "NC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RR MEDICARE",
"identifier": "P01143643",
"state": "NC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Wilmington, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.