Individual provider Active NPI

Ollie Dennis Hooker, LCAS

  • Addiction (Substance Use Disorder) Counselor
  • Raleigh, NC
National Provider Identifier
1902974611
Registry record updated Apr 21, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
1017 Issued in NC
Practice address
4723 Tanglewood Oaks St
Raleigh, NC 27610-3159
Phone
(919) 610-7892
NPI assigned
Dec 1, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 21, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 1017 NC Primary
Mental Health Counselor 101YM0800X 1017 NC

Addresses

Primary practice location

4723 Tanglewood Oaks St
Raleigh, NC 27610-3159

Mailing address

4723 Tanglewood Oaks St
Raleigh, NC 27610-3159
Phone (919) 610-7892

Other identifiers 2

IdentifierTypeStateIssuer
6111894MedicaidNC
142CPOtherNCBLUE CROCC BLUE SHIELD

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

State licenses

LicenseStateTypeSpecialty
1017NCMDProfessional Counselor

NPI Registry JSON

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

{
    "created_epoch": "1164931200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1461196800000",
    "number": "1902974611",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4723 TANGLEWOOD OAKS ST",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276103159",
            "telephone_number": "919-610-7892"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4723 TANGLEWOOD OAKS ST",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276103159",
            "telephone_number": "919-610-7892"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOOKER",
        "first_name": "OLLIE",
        "middle_name": "DENNIS",
        "name_prefix": "Mr.",
        "credential": "LCAS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-01",
        "last_updated": "2016-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NC",
            "license": "1017",
            "primary": true
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NC",
            "license": "1017",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6111894",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROCC BLUE SHIELD",
            "identifier": "142CP",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Raleigh, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 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.