Timothy Gazdziak, LPC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

C2938 Issued in OR

Practice address

1700 NW Civic Dr
Suite 310
Gresham, OR 97030-3770

Phone

(503) 666-8832

Fax

(503) 669-8641

NPI assigned

Jul 20, 2007

Sex

Male

Sole proprietor

No

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

Enrolled in OR

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

Specialty

Mental Health Counselor

Education

Other, 2006

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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

• Kebede Counseling, LLC

  • Marriage & Family Therapist
  • Portland, OR
  • NPI 1487323911
  Medicare reassignment
• Cognitive Care Medical Group LLC

  • Psychiatry Physician
  • Clackamas, OR
  • NPI 1770023186
  NPD (past)

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

{
    "created_epoch": "1184889600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1363305600000",
    "number": "1083814677",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1700 NW CIVIC DR",
            "address_2": "SUITE 310",
            "city": "GRESHAM",
            "state": "OR",
            "postal_code": "970303770",
            "telephone_number": "503-666-8832",
            "fax_number": "503-669-8641"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1700 NW CIVIC DR",
            "address_2": "SUITE 310",
            "city": "GRESHAM",
            "state": "OR",
            "postal_code": "970303770",
            "telephone_number": "503-666-8832",
            "fax_number": "503-669-8641"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAZDZIAK",
        "first_name": "TIMOTHY",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-07-20",
        "last_updated": "2013-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "OR",
            "license": "C2938",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "OR",
            "license": "C2938",
            "primary": true
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "OR",
            "license": "C2938",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sara Garrison
• Jordan Gastelum
• Alicia Dale Gates
• Diane Renee Gatter, EFDA
• Yannete Gaytan
• GD Group LLC
• Feven Gebremeskel, RN
• Mark A. George, O.D.
• Myron J George, LCSW
• Brooke Alexandria Geske, OTD

• Mental Health Counselor in Gresham, OR
• Providers in Gresham, OR by specialty
• Mental Health Counselor in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.