Gregory M Deitchler, MA L.M.F.T., L.P.C.,

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

LMFT2935 Issued in ID

Practice address

3061 S. Meridian Rd.
Suite 100
Meridian, ID 83642

Phone

(208) 350-0330

Fax

(208) 576-6915

NPI assigned

Oct 30, 2007

Last updated

Jan 28, 2019By the provider in NPPES

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1193702400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1548633600000",
    "number": "1013196716",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3061 S. MERIDIAN RD.",
            "address_2": "SUITE 100",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "83642",
            "telephone_number": "208-350-0330",
            "fax_number": "208-576-6915"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3061 S. MERIDIAN RD.",
            "address_2": "SUITE 100",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "83642",
            "telephone_number": "208-350-0330",
            "fax_number": "208-576-6915"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1552 N Crestmont Dr",
            "address_2": "Suite C",
            "address_purpose": "LOCATION",
            "city": "Meridian",
            "state": "ID",
            "postal_code": "836422191",
            "country_code": "US",
            "telephone_number": "208-887-1911",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DEITCHLER",
        "first_name": "GREGORY",
        "middle_name": "M",
        "credential": "MA L.M.F.T., L.P.C.,",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-10-30",
        "last_updated": "2019-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "ID",
            "license": "LPC-949",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "ID",
            "license": "LPC949",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "ID",
            "license": "LMFT2935",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Marriage & Family Therapist in Meridian, ID
• Providers in Meridian, ID by specialty
• Marriage & Family Therapist in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.