GASTON ADOLESCENT CENTER, INC. (NPI# 1093949109) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1093949109 |
| Entity Type | Organization |
| Organization Name | GASTON ADOLESCENT CENTER, INC. |
| Practice Address |
635 Cox Rd Suite B Gastonia NC 28054 |
| Mailing Address |
635 Cox Rd Ste B Gastonia NC 28054-3441 |
| Practice Telephone | 7046917561 |
| Practice Fax Number | 7046917563 |
| Mailing Telephone | 7046917561 |
| Mailing Fax Number | 7046917563 |
| Enumeration Date | 2009-05-05 |
| Last Update Date | 2018-08-16 |
| Authorized Official Name | MR. EDWARD LAWRENCE HALEY (CEO) |
| Authorized Official Telephone | 7046917561 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 251B00000X | Case Management | MHL-036-274 | NC | Agencies |
| N | 101YM0800X |
Counselor Specialization: Mental Health |
Behavioral Health & Social Service Providers | ||
| N | 101YP2500X |
Counselor Specialization: Professional |
Behavioral Health & Social Service Providers | ||
| N | 1041C0700X |
Social Worker Specialization: Clinical |
Behavioral Health & Social Service Providers | ||
| Y | 251S00000X | Community/Behavioral Health | MHL-036-274 | NC | Agencies |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1316 Spencer Mountain Rd, Gastonia, NC 280543045 | 7048243012 | 7046917563 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316236458 | Gaston Adolescent Center, Inc. | Counselor | 635 Cox Rd Ste B, Gastonia, NC 28054 | 2011-03-29 |
| Street Address |
635 COX RD SUITE B |
| City | GASTONIA |
| State | NC |
| Zip Code | 28054 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083612642 | Natu V Patel | Internal Medicine | 635 Cox Rd, Suite E, Gastonia, NC 28054-3441 | 2005-07-08 |
| 1326558263 | Casey Jolly | Social Worker | 635 Cox Rd, B, Gastonia, NC 28054 | 2017-10-05 |
| 1033663885 | Ashleigh Fogg | Social Worker | 635 Cox Rd, Suite B, Gastonia, NC 28054-3424 | 2016-08-10 |
| 1124572979 | Lakeysha Marquita Sawyer | Social Worker | 635 Cox Rd, Suite B, Gastonia, NC 28054-3424 | 2016-08-10 |
| 1821462805 | John Russell Davenport | Counselor | 635 Cox Rd, Suite B, Gastonia, NC 28054-3424 | 2015-11-13 |
| 1205202165 | Courtney Boller | Marriage & Family Therapist | 635 Cox Rd, Unit B, Gastonia, NC 28054-3424 | 2015-08-14 |
| 1730562067 | Tia Mintz | Social Worker | 635 Cox Rd, Suite B, Gastonia, NC 28054-3424 | 2015-07-06 |
| 1407254212 | Barbretta Cook | Counselor | 635 Cox Rd, Gastonia, NC 28054-3424 | 2014-12-10 |
| 1487058699 | Michael Carr Sumner | Social Worker | 635 Cox Rd, Gastonia, NC 28054-3424 | 2014-10-17 |
| 1972895175 | Keosha D.v. Montgomery | Counselor | 635 Cox Rd, Gastonia, NC 28054-3424 | 2011-05-05 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225671423 | Michaela Karsyn Morris | Behavioral Analyst | 2875 Court Dr. B, Gastonia, NC 28054 | 2019-10-21 |
| 1982263810 | Brenda Sue Fox | Occupational Therapist | Brian Center, 969 Cox Rd, Gastonia, NC 28054 | 2019-06-13 |
| 1174096911 | Carolinas Hometown Respiratory LLC | Durable Medical Equipment & Medical Supplies | 469 Hospital Drive, Suite B1, Gastonia, NC 28054 | 2019-01-04 |
| 1255801817 | Jarae Mcswain | Counselor | 1558 Union Road, Ste F, Gastonia, NC 28054 | 2018-11-27 |
| 1427549807 | Alterman & Dhillon Charlotte Metro, Pplc | Dentist | 2205 E. Franklin Blvd, Ste 110, Gastonia, NC 28054 | 2018-05-22 |
| 1871083147 | Terrence Lamont Campbell | Dentist | 2641 Court Dr Ste A, Gastonia, NC 28054 | 2018-05-13 |
| 1861995367 | Jefferson and Jefferson LLC. | Respite Care | 945 East 6 Ave, Gastonia, NC 28054 | 2018-03-12 |
| 1790154912 | Tyler Adcock | Pharmacist | 2324 South New Hope Rd, Gastonia, NC 28054 | 2015-09-17 |
| 1922481894 | Alesha Nicole Logan | Nurse Practitioner | 1895 Hoffman Rd Ste A, Gastonia, NC 28054 | 2015-07-09 |
| 1457732596 | Buffie Baker Eller | Counselor | 2005 Flint Lane, Gastonia, NC 28054 | 2015-06-15 |
| Find all providers in zip 28054 | ||||
| Taxonomy Code | 251S00000X |
| Grouping | Agencies |
| Classification | Community/Behavioral Health |
| A private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, mental retardation, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day support, prevocational services, residential support, therapeutic and supportive consultation, environmental modifications, intensive in-home therapy and day treatment, in addition to traditional mental health and behavioral treatment. |
| Notes: Source: National Medicaid EDI HIPAA NPI Sub Work Group [1/1/2007: modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821568759 | Grace Therapeutic Counseling Pllc | Community/Behavioral Health | 436 E Long Ave Ste 1, Gastonia, NC 28054-2543 | 2018-12-04 |
| 1306376660 | Foundations Education Academy LLC | Community/Behavioral Health | 1008 Union Rd Ste B, Gastonia, NC 28054-5590 | 2017-06-19 |
| 1972052728 | Round Table Coaching and Consulting | Community/Behavioral Health | 1554 Union Rd Ste 6c, Gastonia, NC 28054-5581 | 2016-09-21 |
| 1760939615 | The Groves Counseling Center | Community/Behavioral Health | 2005 Flint Ln, Gastonia, NC 28054-3334 | 2016-09-08 |
| 1376097162 | Zoe Counseling and Consulting Pllc | Community/Behavioral Health | 1550 Union Rd Ste A, Gastonia, NC 28054-5522 | 2016-08-09 |
| 1669825436 | Monarch In Albemarle | Community/Behavioral Health | 1252 Union Rd, D, Gastonia, NC 28054-0505 | 2016-07-18 |
| 1710355698 | Rha Health Services, Inc. | Community/Behavioral Health | 1564 Union Rd Ste A, Gastonia, NC 28054-5302 | 2015-09-09 |
| 1255746467 | Community Resource Solutions, LLC - Sc | Community/Behavioral Health | 1566 Union Rd Ste A, Gastonia, NC 28054-5301 | 2014-06-25 |
| 1013345586 | Monarch | Community/Behavioral Health | 680 Clyde St, Gastonia, NC 28052-7720 | 2013-10-21 |
| 1942559075 | Alternative Community Penalties Program, Inc. | Community/Behavioral Health | 410 W Franklin Blvd, Suite 20, Gastonia, NC 28052-2807 | 2012-09-05 |
| Find all providers in GASTONIA | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.