Derek J Gale, LPC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

C2673 Issued in OR

Practice address

1112 NW Circle Blvd
Corvallis, OR 97330-1462

Phone

(541) 768-1221

NPI assigned

Apr 3, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Interoperability endpoints

• Direct secure messaging: dgale130124@samhealth.direct-ci.com

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

{
    "created_epoch": "1175558400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723766400000",
    "number": "1205957230",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1189",
            "city": "CORVALLIS",
            "state": "OR",
            "postal_code": "973391189"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1112 NW CIRCLE BLVD",
            "city": "CORVALLIS",
            "state": "OR",
            "postal_code": "973301462",
            "telephone_number": "541-768-1221"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3517 NW Samaritan Dr Ste 101",
            "address_purpose": "LOCATION",
            "city": "Corvallis",
            "state": "OR",
            "postal_code": "973303768",
            "country_code": "US",
            "telephone_number": "541-768-4620",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GALE",
        "first_name": "DEREK",
        "middle_name": "J",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-03",
        "last_updated": "2024-08-16",
        "certification_date": "2024-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "OR",
            "license": "C2673",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "dgale130124@samhealth.direct-ci.com",
            "affiliation": "N",
            "address_1": "1112 NW Circle Blvd",
            "city": "Corvallis",
            "state": "OR",
            "country_code": "US",
            "postal_code": "973301462",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Candace June Gagnon, THW
• Edward Wilson Gaines
• Andie Marie Gaipo
• Alexandra Lucille Gaither, DO
• Amanda Galbreath
• Angie Marie Gallagher
• Christine Dawn Gallagher
• James C Gallagher, PT
• Matthew Brett Gallagher, M.S.
• James David Gallant, MD

• Mental Health Counselor in Corvallis, OR
• Providers in Corvallis, OR by specialty
• Mental Health Counselor in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2024; 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.