Justin Wade Gibson, LCSW, LCASA is a
Social Worker - Clinical based in Burgaw, North Carolina. Justin Wade Gibson is licensed to practice in North Carolina (license number C014663) and his current practice location is
309 Progress Dr, Burgaw, North Carolina. He can be reached at his office (for appointments etc.) via phone at
(910) 259-0668.
NPI number for Justin Wade Gibson is 1508408105 and his current mailing address is 615 Shipyard Blvd, Wilmington, North Carolina. He
does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1508408105.
Healthcare Provider's Profile
| Full Name | Justin Wade Gibson |
|---|
| Gender | Male |
|---|
| Speciality | Social Worker - Clinical |
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| Location | 309 Progress Dr, Burgaw, North Carolina |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
|---|
NPI Data:
- NPI Number: 1508408105
- Provider Enumeration Date: 10/15/2019
- Last Update Date: 03/01/2022
Medical Identifiers
Medical identifiers for Justin Wade Gibson such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1508408105 | NPI | - | NPPES |
| 81-5150377 | Medicaid | NC | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | 24725 (North Carolina) | Secondary |
| 1041C0700X | Social Worker - Clinical | C014663 (North Carolina) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Justin Wade Gibson is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Justin Wade Gibson, LCSW, LCASA
615 Shipyard Blvd,
Wilmington, NC 28412-6431
Ph: (910) 343-0145 | Justin Wade Gibson, LCSW, LCASA
309 Progress Dr,
Burgaw, NC 28425-3280
Ph: (910) 259-0668 |
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