Vinnie Gwozdz, LPC, CRC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

C5607 Issued in OR

Practice address

17225 SE Valley View Rd
Portland, OR 97267-6342

Phone

(503) 380-8438

NPI assigned

Jan 23, 2023

Sex

Male

Sole proprietor

Yes

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

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

{
    "created_epoch": "1674432000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674432000000",
    "number": "1164137394",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17225 SE VALLEY VIEW RD",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972676342",
            "telephone_number": "503-380-8438"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17225 SE VALLEY VIEW RD",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972676342",
            "telephone_number": "503-380-8438"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "702 NE Dekum St",
            "address_purpose": "LOCATION",
            "city": "Portland",
            "state": "OR",
            "postal_code": "972113628",
            "country_code": "US",
            "telephone_number": "503-380-8438",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GWOZDZ",
        "first_name": "VINNIE",
        "credential": "LPC, CRC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-01-23",
        "last_updated": "2023-01-23",
        "certification_date": "2023-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "OR",
            "license": "C5607",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Professional Counselor in Portland, OR
• Providers in Portland, OR by specialty
• Professional Counselor in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2023; 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.