Individual provider Active NPI

Cheryll Sue Gaver, CACII

  • Addiction (Substance Use Disorder) Counselor
  • Douglasville, GA
National Provider Identifier
1184250854
Registry record updated Mar 13, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
3106 Issued in GA
Practice address
5833 Stewart Pkwy Ste 103
Douglasville, GA 30135-6933
Phone
(844) 782-2454
Fax
(470) 532-1732
NPI assigned
Mar 13, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 13, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 3106 GA Primary

Addresses

Primary practice location

5833 Stewart Pkwy Ste 103
Douglasville, GA 30135-6933

Mailing address

5833 Stewart Pkwy Ste 103
Douglasville, GA 30135-6933
Phone (470) 532-1722

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

Practice roles

OrganizationSpecialtyStatusNew patients
Stability Rebooted, LLC Addiction (Substance Use Disorder) CurrentSince Mar 22, 2020 Accepting new patients

Locations

5833 Stewart Pkwy
Ste 103
Douglasville, GA 30135
Phone (844) 782-2454

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1584057600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1584057600000",
    "number": "1184250854",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5833 STEWART PKWY STE 103",
            "city": "DOUGLASVILLE",
            "state": "GA",
            "postal_code": "301356933",
            "telephone_number": "470-532-1722",
            "fax_number": "470-532-1732"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5833 STEWART PKWY STE 103",
            "city": "DOUGLASVILLE",
            "state": "GA",
            "postal_code": "301356933",
            "telephone_number": "844-782-2454",
            "fax_number": "470-532-1732"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAVER",
        "first_name": "CHERYLL",
        "middle_name": "SUE",
        "credential": "CACII",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-03-13",
        "last_updated": "2020-03-13",
        "certification_date": "2020-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "GA",
            "license": "3106",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Douglasville, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2020; 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.