Individual provider Active NPI

John Gawboy

  • Mental Health Counselor
  • Burnsville, MN
National Provider Identifier
1043638653
Registry record updated Apr 1, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
753 Issued in MN
Practice address
1751 Southcross Dr W
Burnsville, MN 55306-7012
Phone
(952) 892-7690
NPI assigned
Apr 1, 2014
Last updated
Apr 1, 2014By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 1, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 753 MN Primary

Addresses

Primary practice location

1751 Southcross Dr W
Burnsville, MN 55306-7012

Mailing address

1751 Southcross Dr W
Burnsville, MN 55306-7012

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240208003950 MN Practitioner - Mental Health Counselor 0345683074 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Patricia Verby Psychological Services IncGroup PAC ID 2163525031, 9 clinicians

Practice addresses (Care Compare)

1751 Southcross Dr W
Burnsville, MN 55306-7012
Phone 9528927690100

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
753MNMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Patricia Verby Psychological Services Inc CurrentSince Jan 1, 2024 Accepting new patients

Locations

1751 Southcross Dr W
Burnsville, MN 55306
Phone (952) 892-7690

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1396310400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1396310400000",
    "number": "1043638653",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1751 SOUTHCROSS DR W",
            "city": "BURNSVILLE",
            "state": "MN",
            "postal_code": "553067012"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1751 SOUTHCROSS DR W",
            "city": "BURNSVILLE",
            "state": "MN",
            "postal_code": "553067012",
            "telephone_number": "952-892-7690"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAWBOY",
        "first_name": "JOHN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-04-01",
        "last_updated": "2014-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MN",
            "license": "753",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Burnsville, MN

Sources for this page

Verify at the official NPI Registry.