Individual provider Active NPI

Gilbert K Ghong, LPCC

  • Professional Counselor
  • Lake Elmo, MN
National Provider Identifier
1164061420
Registry record updated Dec 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
4358 Issued in MN
Practice address
8550 Hudson Blvd N
Lake Elmo, MN 55042-5500
Phone
(651) 254-8580
NPI assigned
Jan 3, 2020
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 9, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X
Professional Counselor 101YP2500X 4358 MN Primary

Addresses

Primary practice location

8550 Hudson Blvd N
Lake Elmo, MN 55042-5500

Mailing address

1900 Silver Lake Rd NW Ste 110
New Brighton, MN 55112-1789
Phone (651) 746-2392

Other practice location 1

1520 Granada Ave N Apt 104
Oakdale, MN 55128-4238
Phone (651) 246-6202

Other practice location 2

1900 Silver Lake Rd NW Ste 110
New Brighton, MN 55112-1789
Phone (651) 746-2392

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
I20240906000817 MN Practitioner - Mental Health Counselor 0143760066 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Group Health IncGroup PAC ID 1759293954, 1,627 clinicians

Practice addresses (Care Compare)

8600 Nicollet Ave
Bloomington, MN 55420-2824
Phone (952) 884-1148

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1578009600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733702400000",
    "number": "1164061420",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1900 SILVER LAKE RD NW STE 110",
            "city": "NEW BRIGHTON",
            "state": "MN",
            "postal_code": "551121789",
            "telephone_number": "651-746-2392"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8550 HUDSON BLVD N",
            "city": "LAKE ELMO",
            "state": "MN",
            "postal_code": "550425500",
            "telephone_number": "651-254-8580"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1520 Granada Ave N Apt 104",
            "address_purpose": "LOCATION",
            "city": "Oakdale",
            "state": "MN",
            "postal_code": "551284238",
            "country_code": "US",
            "telephone_number": "651-246-6202",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1900 Silver Lake Rd NW Ste 110",
            "address_purpose": "LOCATION",
            "city": "New Brighton",
            "state": "MN",
            "postal_code": "551121789",
            "country_code": "US",
            "telephone_number": "651-746-2392",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GHONG",
        "first_name": "GILBERT",
        "middle_name": "K",
        "credential": "LPCC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-01-03",
        "last_updated": "2024-12-09",
        "certification_date": "2024-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MN",
            "license": "4358",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Elmo, MN

Sources for this page

Verify at the official NPI Registry.