| Doctor Name: | MR. GARY CLAYTON ROBERSON |
| NPI Number: | 1366887986 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | MS, LCAS, LPCA, CRC |
| License Number: | 2348 |
| Business Practice Address: | 1191 Charlie Branch Rd Winterville, NC - 285908054 |
| Business Phone Number: | 2524124594 |
| Business Fax Number: | |
| Mailing Address: | 1191 Charlie Branch Rd, WINTERVILLE |
| State: | NC |
| Postal Code: | 285908054 |
| Phone Number: | 2524124594 |
| Fax Number: | |
| NPI Enumeration Date: | 05/09/2013 |
| NPI Last Update Date: | 05/09/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YA0400X |
| License Number: | 2348 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | NC |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Addiction (Substance Use Disorder) |
| Taxonomy Definition: | |