Active NPI
Jennifer Anne Faniel, LPC
- Counselor
- Jacksonville, NC
National Provider Identifier
1922200765
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counselor
- License
- 6570
- Practice address
- 3080 Henderson Dr
Jacksonville, NC 28546-5246 - Phone
- (910) 938-9833
- Fax
- (910) 938-9835
- NPI assigned
- Jun 4, 2007
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | 6570 | NC | Primary |
Addresses
Primary practice location
3080 Henderson Dr
Jacksonville, NC 28546-5246
Mailing address
3080 Henderson Dr
Jacksonville, NC 28546-5246
Phone (910) 938-9833
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 6103584 | Medicaid | NC |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 6570 | NC | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1180915200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1300233600000",
"number": "1922200765",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3080 HENDERSON DR",
"city": "JACKSONVILLE",
"state": "NC",
"postal_code": "285465246",
"telephone_number": "910-938-9833",
"fax_number": "910-938-9835"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3080 HENDERSON DR",
"city": "JACKSONVILLE",
"state": "NC",
"postal_code": "285465246",
"telephone_number": "910-938-9833",
"fax_number": "910-938-9835"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FANIEL",
"first_name": "JENNIFER",
"middle_name": "ANNE",
"name_prefix": "Mrs.",
"credential": "LPC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-06-04",
"last_updated": "2011-03-16",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": "NC",
"license": "6570",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "6103584",
"state": "NC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Jacksonville, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.