NPIMap

Organization Active NPI

Harmony 360 Counseling

  • Clinical Social Worker
  • Wake Forest, NC
National Provider Identifier
1235709692
Registry record updated May 11, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Legal business name
HARMONY 360 COUNSELING
Practice address
110 Capcom Ave Ste 202
Wake Forest, NC 27587-6531
Phone
(919) 867-0360
Fax
(877) 920-1934
NPI assigned
Jun 29, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 11, 2026

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

Authorized official

Name
Mrs. Kristian Antionette Gibson-FordNPI 1841781119
Title
Owner
Phone
(919) 867-0360

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YM0800X
Clinical Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041C0700X Primary
Marriage & Family TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 106H00000X
Physician AssistantGroup: 193200000X MULTI-SPECIALTY GROUP 363A00000X
Family Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LF0000X
Psychiatric/Mental Health Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LP0808X

Addresses

Primary practice location

110 Capcom Ave Ste 202
Wake Forest, NC 27587-6531

Mailing address

110 Capcom Ave Ste 202
Wake Forest, NC 27587-6531
Phone (919) 867-0360

Other practice location 1

3323 Cotton Press St
Raleigh, NC 27614-8675
Phone (919) 867-0360

Other practice location 2

6 Consultant Pl Ste 200
Durham, NC 27707-3598
Phone (919) 867-0360

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20260320003276 NC Part B Supplier - Clinic/Group Practice 6002390671 Receives reassigned benefits from 2 practitioners
Practice locations: Durham, NC; Wake Forest, NC

National Provider Directory

National Provider Directory

Locations

14460 Falls of Neuse Rd
Ste 149298
Raleigh, NC 27614

110 Capcom Ave
Ste 202
Wake Forest, NC 27587
Phone (919) 488-1444

Practitioners & affiliated clinicians

Practitioners 13

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1624924800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1778457600000",
    "number": "1235709692",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 CAPCOM AVE STE 202",
            "city": "WAKE FOREST",
            "state": "NC",
            "postal_code": "275876531",
            "telephone_number": "919-867-0360",
            "fax_number": "877-920-1934"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 CAPCOM AVE STE 202",
            "city": "WAKE FOREST",
            "state": "NC",
            "postal_code": "275876531",
            "telephone_number": "919-867-0360",
            "fax_number": "877-920-1934"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3323 Cotton Press St",
            "address_purpose": "LOCATION",
            "city": "Raleigh",
            "state": "NC",
            "postal_code": "276148675",
            "country_code": "US",
            "telephone_number": "919-867-0360",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6 Consultant Pl Ste 200",
            "address_purpose": "LOCATION",
            "city": "Durham",
            "state": "NC",
            "postal_code": "277073598",
            "country_code": "US",
            "telephone_number": "919-867-0360",
            "fax_number": "877-920-1934",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "HARMONY 360 COUNSELING",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-06-29",
        "last_updated": "2026-05-11",
        "certification_date": "2026-05-11",
        "status": "A",
        "authorized_official_last_name": "GIBSON-FORD",
        "authorized_official_first_name": "KRISTIAN",
        "authorized_official_middle_name": "ANTIONETTE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "919-867-0360",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Marriage & Family Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wake Forest, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.