NPIMap

Individual provider Active NPI

Bobby Faison, LCAS

  • Addiction (Substance Use Disorder) Counselor
  • Henderson, NC
National Provider Identifier
1235285032
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
875 Issued in NC
Practice address
208 N Garnett St
Suite F.
Henderson, NC 27536-4673
Phone
(252) 433-0300
Fax
(252) 433-8054
NPI assigned
Jan 25, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 875 NC Primary

Addresses

Primary practice location

208 N Garnett St
Suite F.
Henderson, NC 27536-4673

Mailing address

208 N Garnett St
Suite F.
Henderson, NC 27536-4673
Phone (252) 433-0300

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
875NCMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Prodigious Counseling Services, LLC Past Accepting new patients

Organizations & group practices 4

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": "1169683200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1235285032",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "208 N GARNETT ST",
            "address_2": "SUITE F.",
            "city": "HENDERSON",
            "state": "NC",
            "postal_code": "275364673",
            "telephone_number": "252-433-0300",
            "fax_number": "252-433-8054"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "208 N GARNETT ST",
            "address_2": "SUITE F.",
            "city": "HENDERSON",
            "state": "NC",
            "postal_code": "275364673",
            "telephone_number": "252-433-0300",
            "fax_number": "252-433-8054"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAISON",
        "first_name": "BOBBY",
        "name_prefix": "Mr.",
        "credential": "LCAS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-25",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NC",
            "license": "875",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Henderson, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.