Active NPI
Telisa Foots Gibson
- Clinical Social Worker
- Fort Bragg, NC
National Provider Identifier
1609836808
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 000958
- Practice address
- 2817 Rock Merritt
Fort Bragg, NC 28310-7324 - Phone
- (910) 907-9078
- NPI assigned
- Mar 23, 2006
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 000958 | NC | Primary |
Addresses
Primary practice location
2817 Rock Merritt
Fort Bragg, NC 28310-7324
Mailing address
2817 Rock Merritt Avenue
Fort Bragg, NC 28310
Phone (910) 907-9078
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 |
|---|---|---|---|
| 000958 | NC | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1143072000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1754438400000",
"number": "1609836808",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2817 ROCK MERRITT AVENUE",
"city": "FORT BRAGG",
"state": "NC",
"postal_code": "28310",
"telephone_number": "910-907-9078"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2817 ROCK MERRITT",
"city": "FORT BRAGG",
"state": "NC",
"postal_code": "283107324",
"telephone_number": "910-907-9078"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GIBSON",
"first_name": "TELISA",
"middle_name": "FOOTS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-03-23",
"last_updated": "2025-08-06",
"certification_date": "2025-08-06",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "NC",
"license": "000958",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fort Bragg, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.