Individual provider Active NPI

Edward Garrison, LCAS-A

  • Addiction (Substance Use Disorder) Counselor
  • Raleigh, NC
National Provider Identifier
1861730095
Registry record updated Apr 10, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
2769-A Issued in NC
Practice address
2840 Gresham Grove LN Apt 102
Raleigh, NC 27615-8065
Phone
(704) 400-2010
NPI assigned
Jan 23, 2013
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 10, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 2769-A NC Primary

Addresses

Primary practice location

2840 Gresham Grove LN Apt 102
Raleigh, NC 27615-8065

Mailing address

2840 Gresham Grove LN Apt 102
Raleigh, NC 27615-8065
Phone (704) 400-2010

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

LicenseStateTypeSpecialty
2769-ANCMDAddiction (Substance Use Disorder) Counselor

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1358899200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1523318400000",
    "number": "1861730095",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2840 GRESHAM GROVE LN APT 102",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276158065",
            "telephone_number": "704-400-2010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2840 GRESHAM GROVE LN APT 102",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276158065",
            "telephone_number": "704-400-2010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GARRISON",
        "first_name": "EDWARD",
        "credential": "LCAS-A",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-01-23",
        "last_updated": "2018-04-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NC",
            "license": "2769-A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Raleigh, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2018; 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.