Individual provider Active NPI

Gary Stephen Kaufman, LCMHCS

  • Professional Counselor
  • Pinehurst, NC
National Provider Identifier
1902909989
Registry record updated Jul 8, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
2879 Issued in NC
Practice address
205 Memorial Dr
Pinehurst, NC 28374-8712
Phone
(910) 295-6853
NPI assigned
Sep 6, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 291 NC
Mental Health Counselor 101YM0800X S2879 NC
Professional Counselor 101YP2500X 2879 NC Primary

Addresses

Primary practice location

205 Memorial Dr
Pinehurst, NC 28374-8712

Mailing address

2212 Hwy 731 W
Mount Gilead, NC 27306
Phone (704) 301-2821

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
291NCMDClinical Psychologist
2879NCMDAthletic Trainer

Practice roles

OrganizationSpecialtyStatusNew patients
Daymark Recovery Services, Inc. Mental Health CurrentSince Jan 1, 2024 Accepting new patients

Locations

284 Executive Park Dr
Ste 100
Kannapolis, NC 28025
Phone (704) 939-1118

1104A S Main St
Lexington, NC 27292
Phone (336) 300-8836

205 Memorial Dr
Pinehurst, NC 28374
Phone (910) 295-2040

2129 Statesville Blvd
Salisbury, NC 28147
Phone (704) 633-3616

Interoperability endpoints

  • Direct secure messaging: gary.kaufman.p1@direct.daymarkrecovery.nextgenshare.com

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.

NPI Registry JSON

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

{
    "created_epoch": "1157500800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1657238400000",
    "number": "1902909989",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2212 HWY 731 W",
            "city": "MOUNT GILEAD",
            "state": "NC",
            "postal_code": "27306",
            "telephone_number": "704-301-2821"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "205 MEMORIAL DR",
            "city": "PINEHURST",
            "state": "NC",
            "postal_code": "283748712",
            "telephone_number": "910-295-6853"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAUFMAN",
        "first_name": "GARY",
        "middle_name": "STEPHEN",
        "name_prefix": "Dr.",
        "credential": "LCMHCS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-06",
        "last_updated": "2022-07-08",
        "certification_date": "2022-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NC",
            "license": "291",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NC",
            "license": "S2879",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NC",
            "license": "2879",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pinehurst, NC

Sources for this page

Verify at the official NPI Registry.