Active NPI
Timothy Gant, LPC, LCAS, CSI
- Professional Counselor
- Fayetteville, NC
National Provider Identifier
1801126909
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 8839
- Practice address
- 1521 Owen Park LN
Fayetteville, NC 28304-3454 - Phone
- (910) 321-6006
- Fax
- (877) 795-6252
- NPI assigned
- Jan 12, 2010
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | 8839 | NC | |
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 1876 | NC | |
| Mental Health Counselor | 101YM0800X | 8839 | NC | |
| Professional Counselor | 101YP2500X | 8839 | NC | Primary |
Addresses
Primary practice location
1521 Owen Park LN
Fayetteville, NC 28304-3454
Mailing address
1521 Owen Park LN
Fayetteville, NC 28304-3454
Phone (910) 321-6006
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 6601052 | Medicaid | NC |
Other names 1
- Tim Gant
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 |
|---|---|---|---|
| 8839 | NC | MD | Professional Counselor |
| 1876 | NC | MD | Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| A Brighter Future Medical | Current | Accepting new patients | |
| Ernesto J F Graham MD PA | Current | Accepting new patients |
Locations
4140 Ferncreek Dr
Ste 300
Fayetteville, NC 28314
Phone (910) 321-6006
1521 Owen Park Ln
Fayetteville, NC 28304
Phone (910) 223-7420
Organizations & group practices 2
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.
-
- Nurse Practitioner
- Fayetteville, NC
- NPI 1538491642
-
- Obstetrics & Gynecology Physician
- Fayetteville, NC
- NPI 1528161668
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1263254400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1753747200000",
"number": "1801126909",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1521 OWEN PARK LN",
"city": "FAYETTEVILLE",
"state": "NC",
"postal_code": "283043454",
"telephone_number": "910-321-6006",
"fax_number": "877-795-6252"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1521 OWEN PARK LN",
"city": "FAYETTEVILLE",
"state": "NC",
"postal_code": "283043454",
"telephone_number": "910-321-6006",
"fax_number": "877-795-6252"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GANT",
"first_name": "TIMOTHY",
"credential": "LPC, LCAS, CSI",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2010-01-12",
"last_updated": "2025-07-29",
"certification_date": "2025-07-29",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": "NC",
"license": "8839",
"primary": false
},
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "NC",
"license": "1876",
"primary": false
},
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "NC",
"license": "8839",
"primary": false
},
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "NC",
"license": "8839",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "6601052",
"state": "NC"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "TIM",
"last_name": "GANT",
"credential": "LPC, LCAS, ICAADC",
"code": "5",
"type": "Other Name"
}
]
}
Other providers in Fayetteville, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 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.