Individual provider Active NPI

Sharon Grace King-O'Connor, LPC

  • Professional Counselor
  • Statesville, NC
National Provider Identifier
1912159898
Registry record updated Oct 4, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
7421 Issued in NC
Practice address
503 Brookdale
Statesville, NC 28677-1214
Phone
(704) 806-4606
NPI assigned
Oct 22, 2008
Last updated
Oct 4, 2012By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 4, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 6401003687 MI
Professional Counselor 101YP2500X 7421 NC Primary

Addresses

Primary practice location

503 Brookdale
Statesville, NC 28677-1214

Mailing address

PO Box 2383
Cornelius, NC 28031
Phone (704) 806-4606

Other identifiers 1

IdentifierTypeStateIssuer
6104327MedicaidNC

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
6401003687MIMDProfessional Counselor
7421NCMDProfessional Counselor

NPI Registry JSON

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

{
    "created_epoch": "1224633600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1349308800000",
    "number": "1912159898",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2383",
            "city": "CORNELIUS",
            "state": "NC",
            "postal_code": "28031",
            "telephone_number": "704-806-4606"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "503 BROOKDALE",
            "city": "STATESVILLE",
            "state": "NC",
            "postal_code": "286771214",
            "telephone_number": "704-806-4606"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KING-O'CONNOR",
        "first_name": "SHARON",
        "middle_name": "GRACE",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-10-22",
        "last_updated": "2012-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MI",
            "license": "6401003687",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NC",
            "license": "7421",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6104327",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Statesville, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2012; 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.