Gary Wayne Ticey

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

Practice address

6605 W Central Ave
Toledo, OH 43617-1000

Phone

(419) 841-7701

NPI assigned

Dec 27, 2017

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

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 and National Provider Directory roles.

• Personal Growth Counseling Services LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Toledo, OH
  • NPI 1023776028
  NPD (past)

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

{
    "created_epoch": "1514332800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698969600000",
    "number": "1184130288",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2005 ASHLAND AVE",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436201703",
            "telephone_number": "419-841-7701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6605 W CENTRAL AVE",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436171000",
            "telephone_number": "419-841-7701"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TICEY",
        "first_name": "GARY",
        "middle_name": "WAYNE",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-12-27",
        "last_updated": "2023-11-03",
        "certification_date": "2023-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "OH",
            "license": "165227",
            "primary": false
        },
        {
            "code": "175T00000X",
            "taxonomy_group": "",
            "desc": "Peer Specialist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Scott Clifford Thurston, ATC, LAT
• Jacob Tiab, M.D.
• Kevin Tibbits
• Tiberiu Avram MD PC
• Samantha J Ticchi-Junkins, PA-C
• Lacinda Sue Tidwell, LPTA
• Raechelle Tidwell
• Kearsten M Tieche, CRNA
• Lauren Tiell
• Jessica Tietje

• Addiction (Substance Use Disorder) Counselor in Toledo, OH
• Providers in Toledo, OH by specialty
• Addiction (Substance Use Disorder) Counselor in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 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.