MR. GARY CLAYTON ROBERSON JR. (NPI# 1366887986) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1366887986 |
| Entity Type | Individual |
| Full Name | MR. GARY CLAYTON ROBERSON JR. |
| Credential | MS, LCAS, LPCA, CRC |
| Practice Address |
1191 Charlie Branch Rd Winterville NC 28590-8054 |
| Practice Telephone | 2524124594 |
| Mailing Telephone | 2524124594 |
| Enumeration Date | 2013-05-09 |
| Last Update Date | 2013-05-09 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
2348 | NC | Behavioral Health & Social Service Providers |
| Y | 101YM0800X |
Counselor Specialization: Mental Health |
A9174 | NC | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629133400 | Gary Alan Roberson | Psychiatry & Neurology | 3550 Highway 468 West, Whitfield, MS 39193-0157 | 2006-12-22 |
| Street Address |
1191 CHARLIE BRANCH RD |
| City | WINTERVILLE |
| State | NC |
| Zip Code | 28590-8054 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427666130 | Domika Dunn | Non-emergency Medical Transport (VAN) | 2634 Mill Street, #3, Winterville, NC 28590 | 2020-07-20 |
| 1417490194 | Sarah Blakely | Counselor | 367 Branchwood Drive, Winterville, NC 28590 | 2016-11-29 |
| 1740671817 | Faith Lewis Hardison | Social Worker | 173 A Emily Dr., Winterville, NC 28590 | 2015-02-11 |
| 1255740932 | Kendal Williams Strickland | Pharmacist | 4240 Nc Hwy 11 South, Winterville, NC 28590 | 2014-08-07 |
| 1396152757 | Patricia Ragin | Counselor | 1200 Freeland Lane, Unit K1, Winterville, NC 28590 | 2014-07-17 |
| 1780941104 | Triniti House of Restoration | Psychiatric Residential Treatment Facility | 485 Marlboro Drive, Winterville, NC 28590 | 2012-04-23 |
| 1295003002 | Linda Peer Fleming | Psychologist | 108-d West Firetower Rd., Teacch South Hall Professional Center, Winterville, NC 28590 | 2011-12-07 |
| 1740595859 | Christina Neverte Sidrak | Pharmacist | 4211 Nc Highway 11 South, Winterville, NC 28590 | 2010-08-12 |
| 1902124993 | Dove United Counseling and Assessment Services | Counselor | 575 S. Square Drive, Apt 98, Winterville, NC 28590 | 2010-05-14 |
| 1841526407 | Kyle Dombach | Pharmacist | 4211 Winterville Parkway, Winterville, NC 28590 | 2009-11-02 |
| Find all providers in zip 28590 | ||||
| Taxonomy Code | 101YM0800X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780285858 | Michelle Tennant | Counselor | 4140 Dudleys Grant Dr Apt C, Winterville, NC 28590-8342 | 2020-11-05 |
| 1033639067 | Dedra Armstrong Gregory | Counselor | 310 Quinn Ct, Winterville, NC 28590-8021 | 2017-06-21 |
| 1588184618 | Franklin Cordell Moore | Counselor | 2637 Camille Dr, Winterville, NC 28590-9786 | 2017-06-20 |
| 1497110357 | Dax Nelson | Counselor | 331 Barrel Dr, Winterville, NC 28590-9219 | 2015-12-20 |
| 1467864579 | Amy Lavelle Barnwell | Counselor | 2725 Cresset Dr, Winterville, NC 28590-6602 | 2014-05-22 |
| 1952739088 | Liasion | Counselor | 405a S Pointe Dr, Winterville, NC 28590-9891 | 2013-10-29 |
| 1588096713 | Allison B Cassell | Counselor | 642 Tabard Rd, Winterville, NC 28590-9189 | 2013-07-30 |
| 1124469879 | Earlisha Leach | Counselor | 4454 Surrey Meadows Dr, Winterville, NC 28590-9834 | 2013-07-10 |
| 1902124993 | Dove United Counseling and Assessment Services | Counselor | 575 S. Square Drive, Apt 98, Winterville, NC 28590 | 2010-05-14 |
| 1235312059 | Leon Johnson | Counselor | 144 Grandifloria Ct, Winterville, NC 28590-8702 | 2007-12-14 |
| Find all providers in WINTERVILLE | ||||
| City | WINTERVILLE |
| Zip Code | 28590 |
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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.