Gary Lynn Marshall, LCASA

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

22508 Issued in NC

Practice address

518 Signal Hill Drive Ext
Statesville, NC 28625-4391

Phone

(704) 873-1114

Fax

(704) 873-9917

NPI assigned

Apr 3, 2017

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Interoperability endpoints

• Direct secure messaging: gary.marshall.p1@direct.daymarkrecovery.nextgenshare.com

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

{
    "created_epoch": "1491177600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1519257600000",
    "number": "1093247546",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "284 EXECUTIVE PARK DR STE 100",
            "city": "CONCORD",
            "state": "NC",
            "postal_code": "280251833",
            "telephone_number": "704-939-1100",
            "fax_number": "704-939-1173"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "518 SIGNAL HILL DRIVE EXT",
            "city": "STATESVILLE",
            "state": "NC",
            "postal_code": "286254391",
            "telephone_number": "704-873-1114",
            "fax_number": "704-873-9917"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARSHALL",
        "first_name": "GARY",
        "middle_name": "LYNN",
        "credential": "LCASA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-04-03",
        "last_updated": "2018-02-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NC",
            "license": "22508",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1093247546",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Brandon Terrell Marion, MD
• Mark B Williamson, MD PA
• Fred Marks, M.D.
• Mary Maikranz Marks, NP
• Larry N Marlin
• Angela Grace Marsk, LCSW
• Bradley A Martin, M.D.
• Brenda K Martin, LCSW MSW
• Gaitrice Martin, MSN, APRN, FNP-BC
• Ana Beatriz Martinez Ruiz, SURGICAL ASSISTANT-C

• Addiction (Substance Use Disorder) Counselor in Statesville, NC
• Providers in Statesville, NC by specialty
• Addiction (Substance Use Disorder) Counselor in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 2018; 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.