GARY JR. ADKISSON (LLPC) – Counselor, NPI 1326455320

GARY JR. ADKISSON (LLPC) is a healthcare provider. based in Warren, Michigan. specializing in MENTAL HEALTH COUNSELOR. They hold the professional credentials LLPC. They hold a License No. 6401014373 (MI). The NPI Number for GARY JR. ADKISSON (LLPC) is 1326455320

Main info

Male
Sole Proprietor
12 Years Of Experience
Accepts Medicare Assignment
Name
GARY JR. ADKISSON (LLPC)
NPI
1326455320
Phone
Not provided
Address
30500 VAN DYKE AVE
Enumeration Date
22 July 2014
Last Update Date
22 July 2014

Doctor Profile

Medical School Name
OTHER
Secondary Phone
5865586868
Graduation Year
2014 (12 years ago)
PAC ID
9133593387
Group Practice PAC ID
2062646979
Professional Enrollment ID
I20250110001339
Address ID
MI480934588WA11662RDXX300
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience36
Completeness75
Years active:11State licenses:1Digital endpointsOther names

2,023 MENTAL HEALTH COUNSELOR in MI

Provider Addresses for GARY JR. ADKISSON (LLPC)

  • 30500 VAN DYKE AVE

    SUITE 209

    WARREN, MI 480932195

    Phone:

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2025-01-10

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20250110001339IMental Health CounselorMITBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 48093)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 2062646979View full group profile
NameSpecialtyState
Mental Health CounselorMI
Nurse PractitionerMI
Clinical Social WorkerMI
Clinical Social WorkerMI
Mental Health CounselorMI
-MI
Mental Health CounselorMI
Mental Health CounselorMI
Mental Health CounselorMI
-MI

Reviews

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Frequently asked questions

What federal number belongs to GARY JR. ADKISSON (LLPC)?
The federal identifier for GARY JR. ADKISSON (LLPC) is NPI 1326455320.
Is GARY JR. ADKISSON (LLPC) currently active in the NPI registry?
CMS-published data lists GARY JR. ADKISSON (LLPC) as an active registrant.
What does GARY JR. ADKISSON (LLPC) treat or focus on?
Patients typically see GARY JR. ADKISSON (LLPC) under the specialty Counselor. Clinical services aligned with this taxonomy classification.
Does GARY JR. ADKISSON (LLPC) practice in Michigan?
You will see Warren, Michigan on file for GARY JR. ADKISSON (LLPC) alongside any extra practice locations.
What if Warren, Michigan seems incomplete?
Street-level detail can be omitted — open the full address list for this NPI.

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