Individual
MR. GARY CLAYTON ROBERSON JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MS, LCAS, LPCA, CRC
Contact information
Practice address
1191 CHARLIE BRANCH RD, WINTERVILLE, NC 28590-8054
(252) 412-4594
Mailing address
1191 CHARLIE BRANCH RD, WINTERVILLE, NC 28590-8054
(252) 412-4594
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
2348
NC
101YM0800X
Mental Health Counselor
Primary
A9174
NC
Other
Enumeration date
05/09/2013
Last updated
05/09/2013
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