Provider Demographics
NPI:1902909989
Name:KAUFMAN, GARY STEPHEN (LCMHCS)
Entity Type:Individual
Prefix:DR
First Name:GARY
Middle Name:STEPHEN
Last Name:KAUFMAN
Suffix:
Gender:M
Credentials:LCMHCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2212 HWY 731 W
Mailing Address - Street 2:
Mailing Address - City:MOUNT GILEAD
Mailing Address - State:NC
Mailing Address - Zip Code:27306
Mailing Address - Country:US
Mailing Address - Phone:704-301-2821
Mailing Address - Fax:
Practice Address - Street 1:205 MEMORIAL DR
Practice Address - Street 2:
Practice Address - City:PINEHURST
Practice Address - State:NC
Practice Address - Zip Code:28374-8712
Practice Address - Country:US
Practice Address - Phone:910-295-6853
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-06
Last Update Date:2022-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC291101YA0400X
NCS2879101YM0800X
NC2879101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health