Healthcare Provider Details

I. General information

NPI: 1205741386
Provider Name (Legal Business Name): AMY GEBAUER LCMHCA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/14/2026
Last Update Date: 08/14/2026
Certification Date: 08/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1400 BATTLEGROUND AVE STE 209E
GREENSBORO NC
27408-8028
US

IV. Provider business mailing address

1400 BATTLEGROUND AVE STE 209E
GREENSBORO NC
27408-8028
US

V. Phone/Fax

Practice location:
  • Phone: 336-383-1665
  • Fax: 336-822-9463
Mailing address:
  • Phone: 336-383-1665
  • Fax: 336-822-9463

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberA23292
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: