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General NPI Number Information
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NPI Number | 1306617543
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Entity Type | Individual
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Provider Name | MELISSA J'AVET GARY LCSW-A
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Gender | Female
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Dates
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Enumeration Date | 01/15/2024
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Last Update Date | 07/24/2025
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Provider Practice Location Address
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Address Line | 1021 X RAY DR
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City | GASTONIA
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State | NC
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Zip | 28054-7489
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Country | US
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Telephone | 704-867-2341
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Fax | 704-867-9019
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Provider Business Mailing Address
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Address Line | 200 E 2ND AVE
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City | GASTONIA
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State | NC
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Zip | 28052-4358
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Country | US
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Telephone | 704-874-1900
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 30101
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | P020099
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License Number State | NC
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