Active NPI
Cyvonne Rush Gaines, LCAS
- Addiction (Substance Use Disorder) Counselor
- Wadesboro, NC
National Provider Identifier
1821225186
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction (Substance Use Disorder) Counselor
- License
- 1375
- Practice address
- 148-C E Morgan St.
Wadesboro, NC 28170 - Phone
- (704) 458-0130
- Fax
- (704) 459-0130
- NPI assigned
- Jun 15, 2009
- Last updated
- Jul 18, 2013
- 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 |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 1375 | NC | Primary |
Addresses
Primary practice location
148-C E Morgan St.
Wadesboro, NC 28170
Mailing address
148-C E Morgan St.
Wadesboro, NC 28170
Phone (704) 458-0130
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 6112112 | Medicaid | NC |
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 |
|---|---|---|---|
| 1375 | NC | MD | Marriage & Family Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1245024000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1374105600000",
"number": "1821225186",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "148-C E MORGAN ST.",
"city": "WADESBORO",
"state": "NC",
"postal_code": "28170",
"telephone_number": "704-458-0130",
"fax_number": "704-459-0130"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "148-C E MORGAN ST.",
"city": "WADESBORO",
"state": "NC",
"postal_code": "28170",
"telephone_number": "704-458-0130",
"fax_number": "704-459-0130"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GAINES",
"first_name": "CYVONNE",
"middle_name": "RUSH",
"name_prefix": "Mrs.",
"credential": "LCAS",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2009-06-15",
"last_updated": "2013-07-18",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "NC",
"license": "1375",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "6112112",
"state": "NC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Wadesboro, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.