Provider Demographics
NPI:1801080122
Name:BRYSON, JERRY CARROLL (LPC, LCAS)
Entity type:Individual
Prefix:MR
First Name:JERRY
Middle Name:CARROLL
Last Name:BRYSON
Suffix:
Gender:M
Credentials:LPC, LCAS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:283 BILTMORE AVE
Mailing Address - Street 2:
Mailing Address - City:ASHEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28801-4157
Mailing Address - Country:US
Mailing Address - Phone:828-252-8748
Mailing Address - Fax:828-252-9512
Practice Address - Street 1:283 BILTMORE AVE
Practice Address - Street 2:
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28801-4157
Practice Address - Country:US
Practice Address - Phone:828-252-8748
Practice Address - Fax:828-252-9512
Is Sole Proprietor?:No
Enumeration Date:2007-08-29
Last Update Date:2007-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1038101Y00000X
NC245101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101Y00000XBehavioral Health & Social Service ProvidersCounselor