Latisha Michelle Gibson, MS,LCAS-A

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

Practice address

Fernandez Community Center
3050 Berks Way
Raleigh, NC 27614

Phone

(919) 900-7438

Fax

(919) 900-7576

NPI assigned

Jul 14, 2023

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

Practice roles

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.

• Fernandez Community Center, LLC

  • Community/Behavioral Health Agency
  • Raleigh, NC
  • NPI 1033465075

  Addiction (Substance Use Disorder)

  NPD (past)

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

{
    "created_epoch": "1689292800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689292800000",
    "number": "1568141752",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2500 NASH ST N STE E2500",
            "city": "WILSON",
            "state": "NC",
            "postal_code": "278961394",
            "telephone_number": "252-227-1376"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "FERNANDEZ COMMUNITY CENTER",
            "address_2": "3050 BERKS WAY",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "27614",
            "telephone_number": "919-900-7438",
            "fax_number": "919-900-7576"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GIBSON",
        "first_name": "LATISHA",
        "middle_name": "MICHELLE",
        "credential": "MS,LCAS-A",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-07-14",
        "last_updated": "2023-07-14",
        "certification_date": "2023-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Debra Luanne Gibson, M.D.
• Elaine S Gibson, LCSW
• Jacqueline Gaillard Gibson, PA-C
• Jazlin Gibson, PT, DPT
• Jean Pennington Gibson, LCSW
• Mary Sybil Gibson, CRNA
• Meredith Prescott Gibson, M.A., CCC-SLP
• Ryan Phillip Gibson, PHARMD
• Terri Gibson, RN
• Damaris Wanjiku Gichuhi

• Addiction (Substance Use Disorder) Counselor in Raleigh, NC
• Providers in Raleigh, NC by specialty
• Addiction (Substance Use Disorder) Counselor in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 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.