Provider Demographics
NPI:1154663706
Name:GASKINS, CYNTHIA LEWIS (LPCS,LCAS,CCS,CSOTS)
Entity type:Individual
Prefix:MS
First Name:CYNTHIA
Middle Name:LEWIS
Last Name:GASKINS
Suffix:
Gender:F
Credentials:LPCS,LCAS,CCS,CSOTS
Other - Prefix:
Other - First Name:CYNTHIA
Other - Middle Name:VERN
Other - Last Name:LEWIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPC,LCAS,CSI,CSOTS
Mailing Address - Street 1:1115 FULCHER LN
Mailing Address - Street 2:
Mailing Address - City:NEW BERN
Mailing Address - State:NC
Mailing Address - Zip Code:28562-2413
Mailing Address - Country:US
Mailing Address - Phone:919-221-8255
Mailing Address - Fax:
Practice Address - Street 1:1115 FULCHER LN
Practice Address - Street 2:
Practice Address - City:NEW BERN
Practice Address - State:NC
Practice Address - Zip Code:28562-2413
Practice Address - Country:US
Practice Address - Phone:919-221-8255
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-03-21
Last Update Date:2020-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC3212101YA0400X
NC10101101YM0800X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCNOO7C3A54513Medicaid