Individual
JACK L MCCONNELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCAS
Contact information
Practice address
327 1ST AVE NW, HICKORY, NC 28601-6122
(828) 695-5900
(828) 695-4256
Mailing address
327 1ST AVE NW, HICKORY, NC 28601-6122
(828) 695-5900
(828) 695-4256
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
1185
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1780888024
—
NC
Enumeration date
06/12/2007
Last updated
08/31/2015
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