Individual provider Active NPI

Gregory Thomas O'Neal, M.S., D.M.H.P

  • Counselor
  • Longview, WA
National Provider Identifier
1265752687
Registry record updated Feb 4, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
License
60158319 Issued in WA
Practice address
921 14TH Avenue
Longview, WA 98632
Phone
(360) 423-0203
Fax
(360) 423-2311
NPI assigned
Jun 8, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 4, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X 60158319 WA Primary

Addresses

Primary practice location

921 14TH Avenue
Longview, WA 98632

Mailing address

921 14TH Avenue
Longview, WA 98632
Phone (360) 423-0203

Other identifiers 1

IdentifierTypeStateIssuer
2097922MedicaidWA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
60158319WAMDCounselor

NPI Registry JSON

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

{
    "created_epoch": "1275955200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1549238400000",
    "number": "1265752687",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "921 14TH AVENUE",
            "city": "LONGVIEW",
            "state": "WA",
            "postal_code": "98632",
            "telephone_number": "360-423-0203",
            "fax_number": "360-577-0269"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "921 14TH AVENUE",
            "city": "LONGVIEW",
            "state": "WA",
            "postal_code": "98632",
            "telephone_number": "360-423-0203",
            "fax_number": "360-423-2311"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "O'NEAL",
        "first_name": "GREGORY",
        "middle_name": "THOMAS",
        "name_prefix": "Mr.",
        "credential": "M.S., D.M.H.P",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-06-08",
        "last_updated": "2019-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "WA",
            "license": "60158319",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2097922",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Longview, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2019; 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.