Active NPI
Gail P Dyne, MFT
- Mental Health Counselor
- Lakeport, CA
National Provider Identifier
1306084124
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- MFC27862
- Practice address
- 149 N Main St Ste 200
Lakeport, CA 95453-4846 - Phone
- (707) 245-8324
- Fax
- (707) 279-4690
- NPI assigned
- Feb 2, 2009
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | MFC27862 | CA | Primary |
Addresses
Primary practice location
149 N Main St Ste 200
Lakeport, CA 95453-4846
Mailing address
2361 East Lake Dr.
Kelseyville, CA 95451
Phone (707) 279-4690
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MFC27862 | CA | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1233532800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1398211200000",
"number": "1306084124",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2361 EAST LAKE DR.",
"city": "KELSEYVILLE",
"state": "CA",
"postal_code": "95451",
"telephone_number": "707-279-4690"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "149 N MAIN ST STE 200",
"city": "LAKEPORT",
"state": "CA",
"postal_code": "954534846",
"telephone_number": "707-245-8324",
"fax_number": "707-279-4690"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DYNE",
"first_name": "GAIL",
"middle_name": "P",
"name_prefix": "Mrs.",
"credential": "MFT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2009-02-02",
"last_updated": "2014-04-23",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "CA",
"license": "MFC27862",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lakeport, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.