Gwendolyn Onumah-Onikoro, LICSW

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

11184 Issued in MN

Practice address

8040 Old Cedar Ave S Ste 101
Bloomington, MN 55425-1211

Phone

(952) 992-9803

NPI assigned

May 20, 2013

Last updated

May 8, 2018By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Alliance Wellness Center LLC

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Bloomington, MN
  • NPI 1184017279
  NPD (past)

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

{
    "created_epoch": "1369008000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1525737600000",
    "number": "1144666090",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2265 YOUNGMAN AVE APT 105E",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551164400",
            "telephone_number": "612-414-7314"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8040 OLD CEDAR AVE S STE 101",
            "city": "BLOOMINGTON",
            "state": "MN",
            "postal_code": "554251211",
            "telephone_number": "952-992-9803"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ONUMAH-ONIKORO",
        "first_name": "GWENDOLYN",
        "name_prefix": "Ms.",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-05-20",
        "last_updated": "2018-05-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MN",
            "license": "11184",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shadiya Beiti Omar I
• Samir Omer
• Vicky Onderi Osoro, RN
• One Agora LLC (One Agora Integrative Health Clinic)
• Ontario Transportation LLC (Ontario transportation)
• Susan Marie Opperman, LICSW
• Opportunity Partners Inc. (Lavine Place)
• Optage Inc (Founders Ridge)
• Optimedicus LLC
• Optimum Kids Care LLC

• Mental Health Counselor in Bloomington, MN
• Providers in Bloomington, MN by specialty
• Mental Health Counselor in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2018; 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.