Individual provider Active NPI

Lauren Marie Gallison, M.S., LPCA

  • Mental Health Counselor
  • Kernersville, NC
National Provider Identifier
1003142779
Registry record updated Aug 21, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
8586 Issued in NC
Practice address
280 Broad St Ste E
Kernersville, NC 27284-2948
Phone
(336) 277-6050
Fax
(336) 992-3141
NPI assigned
Oct 30, 2009
Last updated
Aug 21, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 21, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 8586 NC Primary

Addresses

Primary practice location

280 Broad St Ste E
Kernersville, NC 27284-2948

Mailing address

PO Box 60447
Charlotte, NC 28260-0447
Phone (336) 277-6050

Other practice location 1

110 W Walker Ave
Asheboro, NC 27203-6760
Phone (336) 633-7000 ext. 2414

Other names 1

  • Lauren Marie Grigg Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240626002527 NC Practitioner - Mental Health Counselor 7719421106 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Novant Health Medical Group, LLCGroup PAC ID 1153234893, 2,413 clinicians

Practice addresses (Care Compare)

13815 Professional Ctr Dr
Suite 100
Huntersville, NC 28078-7951
Phone (704) 384-1320

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
8586NCMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Forsyth Memorial Hospital, Inc. Current Accepting new patients
Forsyth Memorial Hospital, Inc. CurrentSince Jul 26, 2024 Accepting new patients
Novant Health Medical Group, LLC Current Accepting new patients
Novant Health Medical Group, LLC CurrentSince Jul 26, 2024 Accepting new patients
Novant Health Medical Group, LLC CurrentSince Jul 26, 2024 Accepting new patients
Forsyth Memorial Hospital, Inc. CurrentSince Jul 26, 2024 Accepting new patients

Locations

1918 Randolph Rd
Ste 400
Charlotte, NC 28207
Phone (704) 384-9437

6301 Stadium Dr
Clemmons, NC 27012
Phone (336) 766-6473

13815 Professional Center Dr
Ste 100
Huntersville, NC 28078
Phone (704) 316-2050

280 Broad St
Ste E
Kernersville, NC 27284
Phone (336) 277-6050

291 Broad St
Kernersville, NC 27284
Phone (336) 993-8181

6620 Shallowford Rd
#200
Lewisville, NC 27023
Phone (336) 757-0258

512 Village Rd
Ste 104
Shallotte, NC 28470
Phone (910) 721-4200

5145 Sellers Rd
Shallotte, NC 28470
Phone (910) 754-4441

207 Old Lexington Rd
Thomasville, NC 27360
Phone (336) 472-2000

309 Pineywood Rd
Thomasville, NC 27360
Phone (336) 474-8921

140 Kimel Park Dr
Ste 200
Winston Salem, NC 27103
Phone (336) 718-3550

175 Kimel Park Dr
Ste 100
Winston Salem, NC 27103
Phone (336) 277-1811

2825 Lyndhurst Ave
Ste 101
Winston Salem, NC 27103
Phone (336) 277-6300

3333 Silas Creek Pkwy
Winston Salem, NC 27103
Phone (336) 277-8800

Networks

  • TN PPO C-SNP
  • devoted network organization-84bf27aa-506a-49c4-8818-702cf5e8efb3
  • devoted network organization-0f7f8d4f-1035-4992-8c02-dc86d12e700e
  • TN PPO
  • devoted network organization-92131eb0-09f2-4173-a140-cf7b381f0cf1

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1256860800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724198400000",
    "number": "1003142779",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 60447",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282600447",
            "telephone_number": "336-277-6050",
            "fax_number": "336-992-3141"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "280 BROAD ST STE E",
            "city": "KERNERSVILLE",
            "state": "NC",
            "postal_code": "272842948",
            "telephone_number": "336-277-6050",
            "fax_number": "336-992-3141"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "110 W Walker Ave",
            "address_purpose": "LOCATION",
            "city": "Asheboro",
            "state": "NC",
            "postal_code": "272036760",
            "country_code": "US",
            "telephone_number": "336-633-7000 x2414",
            "fax_number": "336-625-3817",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GALLISON",
        "first_name": "LAUREN",
        "middle_name": "MARIE",
        "credential": "M.S., LPCA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-10-30",
        "last_updated": "2024-08-21",
        "certification_date": "2024-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NC",
            "license": "8586",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LAUREN",
            "last_name": "GRIGG",
            "middle_name": "MARIE",
            "credential": "M.S., QP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Kernersville, NC

Sources for this page

Verify at the official NPI Registry.