MRS. TANEKA MARIE GIBSON (NPI# 1780187518) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1780187518 |
| Entity Type | Individual |
| Full Name | MRS. TANEKA MARIE GIBSON |
| Credential | CRC, LCMHC, LCAS-A, |
| Practice Address |
163 Stratford Ct Ste 170 Winston Salem NC 27103-1833 |
| Mailing Address |
9805 Statesville Rd Ste 6235 Charlotte NC 28269-7647 |
| Practice Telephone | 3368314051 |
| Mailing Telephone | 3362554394 |
| Enumeration Date | 2018-03-18 |
| Last Update Date | 2020-07-30 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101Y00000X | Counselor | 6401018441 | MI | Behavioral Health & Social Service Providers |
| N | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
LCAS-24448 | NC | Behavioral Health & Social Service Providers |
| N | 101YM0800X |
Counselor Specialization: Mental Health |
13822 | Behavioral Health & Social Service Providers | |
| N | 101YP2500X |
Counselor Specialization: Professional |
13822 | NC | Behavioral Health & Social Service Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1 Centerview Dr Ste 300, Greensboro, NC 274073712 | 3366170469 | |
| 284 Executive Park Dr Ste 100, Concord, NC 280251833 | 7049391100 | 7049391173 |
| 7670 N Point Ct, Winston Salem, NC 271063336 | 3367241412 |
| Street Address |
163 STRATFORD CT STE 170 |
| City | WINSTON SALEM |
| State | NC |
| Zip Code | 27103-1833 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689073652 | Tyshun Tavares Frazier | Counselor | 163 Stratford Ct Ste 170, Winston Salem, NC 27103-1833 | 2014-08-15 |
| 1083215834 | Eric Lawrence Taylor IIi | Counselor | 163 Stratford Ct Ste 170, Winston Salem, NC 27103-1833 | 2020-11-06 |
| 1346858156 | Chelsea Simone White | Counselor | 163 Stratford Ct Ste 170, Winston Salem, NC 27103-1833 | 2020-07-17 |
| 1801441738 | Aisha Briana Welch | Counselor | 163 Stratford Ct Ste 170, Winston Salem, NC 27103-1833 | 2019-08-07 |
| 1528524881 | Amber Khan | Counselor | 163 Stratford Ct Ste 170, Winston Salem, NC 27103-1833 | 2019-02-12 |
| 1649748716 | Janell Fabor | Counselor | 163 Stratford Ct Ste 170, Winston Salem, NC 27103-1833 | 2018-11-07 |
| 1407353725 | Terri Pickett | Counselor | 163 Stratford Ct Ste 170, Winston Salem, NC 27103-1833 | 2018-04-12 |
| 1720501612 | Karen Alane Cauthen | Counselor | 163 Stratford Ct Ste 170, Winston Salem, NC 27103-1833 | 2017-07-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124648126 | Kelly Anne Wales | Pharmacist | 3917-a Westpoint Boulevard, Winston-salem, NC 27103 | 2020-04-20 |
| 1386281533 | Elena Mcginty | Nurse Practitioner | 1225 Creekshire Way, Suite 270, Winston Salem, NC 27103 | 2019-12-06 |
| 1992359442 | Madeline Pryor | Pharmacist | 255 Charlois Drive, Winston Salem, NC 27103 | 2019-08-01 |
| 1215599584 | Palmetto Oxygen LLC | Durable Medical Equipment & Medical Supplies | 1100 S Stratford Road, Building B, Suite 420, Winston Salem, NC 27103 | 2019-07-07 |
| 1548734718 | Trivy Johnson | Specialist | 1384-b Westgate Center Dr., Winston Salem, NC 27103 | 2019-01-21 |
| 1447745047 | Novant Health Rehabilitation Hospital of Winston-salem, LLC | Rehabilitation Hospital | 2475 Hillcrest Center Circle, Winston Salem, NC 27103 | 2018-06-26 |
| 1346740206 | Joseph Miller | Physical Therapist | 1605 Westbrook Dr, Suite 103, Winston-salem, NC 27103 | 2018-02-17 |
| 1548779101 | Kristin Blow | Counselor | 3000 Bethesda Pl Ste 202, Winston Salem, NC 27103 | 2017-09-27 |
| 1891213443 | Alisha Dawn Wilson | Occupational Therapy Assistant | 2101 Homestead Hills Drive, Winston Salem, NC 27103 | 2017-09-05 |
| 1588186969 | Brandy Wilson | Social Worker | 153 Cameron Way Circle, Winston Salem, NC 27103 | 2017-07-07 |
| Find all providers in zip 27103 | ||||
| Taxonomy Code | 101Y00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master’s degree and clinical experience and supervision for licensure or certification. |
| Notes: Sources: Abridged from definitions provided by the National Board of Certified Counselors and the American Association of Pastoral Counselors. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669021994 | Martha B Metzler | Counselor | 121 Reynolda Vlg Ste A, Winston Salem, NC 27106-5126 | 2019-09-09 |
| 1407335953 | Valera Counseling Services, Pllc | Counselor | 4680 Brownsboro Rd Rm A2, Winston Salem, NC 27106-3428 | 2018-08-07 |
| 1477039675 | Fengdi Pei | Counselor | 2325 Hilltop Dr, Winston Salem, NC 27106-4220 | 2018-07-11 |
| 1376059840 | Danielle Clark Moore | Counselor | 500 W 4th St Ste 203, Winston Salem, NC 27101-2782 | 2017-12-20 |
| 1679921597 | Nicholas Chase Salmons | Counselor | 203 S Stratford Rd Ste A, Winston Salem, NC 27103-1872 | 2016-06-01 |
| 1295102002 | Sarah Vavreck | Counselor | 1025 W End Blvd, 1, Winston Salem, NC 27101-2657 | 2015-08-27 |
| 1063893865 | Guruji Products Inc | Counselor | 1801 Olivers Crossing Cir, Winston Salem, NC 27127-7133 | 2015-06-17 |
| 1407253776 | Amy Bond Craver | Counselor | 620 Holly Ave, Winston Salem, NC 27101 | 2014-12-02 |
| 1093136525 | Chantal D Hayes | Counselor | 1348 Westgate Center Dr Ste 202, Winston Salem, NC 27103-2984 | 2013-12-31 |
| 1396095907 | Anita Ellen Fadden | Counselor | 665 W. 4th Street, Winston Salem, NC 27101 | 2012-09-12 |
| Find all providers in WINSTON SALEM | ||||
| City | WINSTON SALEM |
| Zip Code | 27103 |
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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.