Individual provider Active NPI

Erik Muse Gantt, LPC, CADC I

  • Professional Counselor
  • Bend, OR
National Provider Identifier
1154830768
Registry record updated Aug 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
C8692 Issued in OR
Practice address
1128 NW Harriman St
Bend, OR 97703-1947
Phone
(541) 322-7500
Fax
(541) 322-7565
NPI assigned
Sep 26, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 20, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X
Peer Specialist 175T00000X
Professional Counselor 101YP2500X C8692 OR Primary

Addresses

Primary practice location

1128 NW Harriman St
Bend, OR 97703-1947

Mailing address

2577 NE Courtney Dr
Bend, OR 97701-7752
Phone (415) 322-7500

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20240905004420 OR Practitioner - Mental Health Counselor 1153861042 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Deschutes County OregonGroup PAC ID 9638083371, 58 clinicians

Practice addresses (Care Compare)

2577 NE Courtney Dr
Bend, OR 97701-7638
Phone (541) 327-7400

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Deschutes County Oregon Current Accepting new patients
Deschutes County Oregon CurrentSince Aug 18, 2024 Accepting new patients
Deschutes County Oregon CurrentSince Aug 18, 2024 Accepting new patients

Locations

2577 NE Courtney Dr
Bend, OR 97701
Phone (541) 322-7400

1128 NW Harriman St
Bend, OR 97703
Phone (541) 322-7457

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1506384000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724112000000",
    "number": "1154830768",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2577 NE COURTNEY DR",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977017752",
            "telephone_number": "415-322-7500",
            "fax_number": "541-322-7565"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1128 NW HARRIMAN ST",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977031947",
            "telephone_number": "541-322-7500",
            "fax_number": "541-322-7565"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GANTT",
        "first_name": "ERIK",
        "middle_name": "MUSE",
        "credential": "LPC, CADC I",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-09-26",
        "last_updated": "2024-08-20",
        "certification_date": "2024-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "175T00000X",
            "taxonomy_group": "",
            "desc": "Peer Specialist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "OR",
            "license": "C8692",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bend, OR

Sources for this page

Verify at the official NPI Registry.