Active NPI
Leslie Gibson
- Professional Counselor
- Charlotte, NC
National Provider Identifier
1508628967
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 8850
- Practice address
- 224 S Caswell Rd
Charlotte, NC 28204-3214 - Phone
- (704) 313-3088
- NPI assigned
- Jan 30, 2024
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 8850 | SC | Primary |
Addresses
Primary practice location
224 S Caswell Rd
Charlotte, NC 28204-3214
Mailing address
1055 Hunters Run Dr
Tega Cay, SC 29708-8339
Phone (814) 404-9220
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
| License | State | Type | Specialty |
|---|---|---|---|
| 8850 | SC | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1706572800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1706572800000",
"number": "1508628967",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1055 HUNTERS RUN DR",
"city": "TEGA CAY",
"state": "SC",
"postal_code": "297088339",
"telephone_number": "814-404-9220"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "224 S CASWELL RD",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282043214",
"telephone_number": "704-313-3088"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GIBSON",
"first_name": "LESLIE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2024-01-30",
"last_updated": "2024-01-30",
"certification_date": "2024-01-30",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Counselor, Professional",
"state": "SC",
"license": "8850",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Charlotte, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.