Active NPI
Bryson Gibbs
- Addiction (Substance Use Disorder) Counselor
- Cary, NC
National Provider Identifier
1629580691
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction (Substance Use Disorder) Counselor
- License
- 22925
- Practice address
- 128 Quade Dr
Cary, NC 27513-7400 - Phone
- (919) 654-8349
- NPI assigned
- Oct 31, 2017
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 22925 | NC | Primary |
Addresses
Primary practice location
128 Quade Dr
Cary, NC 27513-7400
Mailing address
1927 St Marys Rd
Hillsborough, NC 27278-8428
Phone (615) 428-6314
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 |
|---|---|---|---|
| 22925 | NC | MD | Addiction (Substance Use Disorder) Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Psychological Healthcare, PLLC | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Professional Counselor
- Syracuse, NY
- NPI 1922109578
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1509408000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1509408000000",
"number": "1629580691",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1927 ST MARYS RD",
"city": "HILLSBOROUGH",
"state": "NC",
"postal_code": "272788428",
"telephone_number": "615-428-6314"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "128 QUADE DR",
"city": "CARY",
"state": "NC",
"postal_code": "275137400",
"telephone_number": "919-654-8349"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GIBBS",
"first_name": "BRYSON",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2017-10-31",
"last_updated": "2017-10-31",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "NC",
"license": "22925",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Cary, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.