Individual provider Active NPI

Gina Yvette Bussey, LCSW LCAS CCS

  • Clinical Social Worker
  • Raleigh, NC
National Provider Identifier
1174825467
Registry record updated Jun 19, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
C014673 Issued in NC
Practice address
5057 Neuse Commons LN
Raleigh, NC 27616-8349
Phone
(919) 825-6087
NPI assigned
Nov 19, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 19, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X C014673 NC Primary

Addresses

Primary practice location

5057 Neuse Commons LN
Raleigh, NC 27616-8349

Mailing address

5057 Neuse Commons LN
Raleigh, NC 27616-8349
Phone (919) 825-6087

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
C014673NCMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1290124800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687132800000",
    "number": "1174825467",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5057 NEUSE COMMONS LN",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276168349",
            "telephone_number": "919-825-6087"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5057 NEUSE COMMONS LN",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276168349",
            "telephone_number": "919-825-6087"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUSSEY",
        "first_name": "GINA",
        "middle_name": "YVETTE",
        "name_prefix": "Ms.",
        "credential": "LCSW LCAS CCS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-11-19",
        "last_updated": "2023-06-19",
        "certification_date": "2023-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "C014673",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Raleigh, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2023; 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.