Individual provider Active NPI

Emily Gillard, LPCA, M.ED.

  • Mental Health Counselor
  • Bend, OR
National Provider Identifier
1336837152
Registry record updated Apr 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
R8284 Issued in OR
Practice address
20970 King Hezekiah Way
Bend, OR 97702-2849
Phone
(503) 481-5795
NPI assigned
Apr 28, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 28, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X R8284 OR Primary

Addresses

Primary practice location

20970 King Hezekiah Way
Bend, OR 97702-2849

Mailing address

20970 King Hezekiah Way
Bend, OR 97702-2849
Phone (503) 481-5795

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 Education

State licenses

LicenseStateTypeSpecialty
R8284ORMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1682640000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1682640000000",
    "number": "1336837152",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20970 KING HEZEKIAH WAY",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977022849",
            "telephone_number": "503-481-5795"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20970 KING HEZEKIAH WAY",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977022849",
            "telephone_number": "503-481-5795"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GILLARD",
        "first_name": "EMILY",
        "credential": "LPCA, M.ED.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-04-28",
        "last_updated": "2023-04-28",
        "certification_date": "2023-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "OR",
            "license": "R8284",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bend, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 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.