Active NPI
Joshua Dwight Gregory, MS
- Mental Health Counselor
- Bement, IL
National Provider Identifier
1114651197
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 180-005175
- Practice address
- 285 W Moultrie St
Bement, IL 61813-1458 - Phone
- (309) 825-4058
- NPI assigned
- Jul 14, 2022
- Last updated
- Jul 14, 2022
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 180-005175 | IL | Primary |
Addresses
Primary practice location
285 W Moultrie St
Bement, IL 61813-1458
Mailing address
285 W Moultrie St
Bement, IL 61813-1458
Phone (309) 825-4058
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 180-005175 | IL | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1657756800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1657756800000",
"number": "1114651197",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "285 W MOULTRIE ST",
"city": "BEMENT",
"state": "IL",
"postal_code": "618131458",
"telephone_number": "309-825-4058"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "285 W MOULTRIE ST",
"city": "BEMENT",
"state": "IL",
"postal_code": "618131458",
"telephone_number": "309-825-4058"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GREGORY",
"first_name": "JOSHUA",
"middle_name": "DWIGHT",
"name_prefix": "Mr.",
"credential": "MS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2022-07-14",
"last_updated": "2022-07-14",
"certification_date": "2022-07-14",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "IL",
"license": "180-005175",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bement, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.