Active NPI
Marty Ray Huckins, CAP, CCDC III, ICADC
- Addiction (Substance Use Disorder) Counselor
- Gillette, WY
National Provider Identifier
1356624019
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction (Substance Use Disorder) Counselor
- License
- 052
- Practice address
- 501 S Burma Ave
Gillette, WY 82716-3426 - Phone
- (307) 688-5000
- Fax
- (307) 688-5015
- NPI assigned
- Sep 20, 2011
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 052 | WY | Primary |
Addresses
Primary practice location
501 S Burma Ave
Gillette, WY 82716-3426
Mailing address
501 South Burma Ave.
Gillette, WY 82716-3426
Phone (307) 688-5000
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 |
|---|---|---|---|
| 052 | WY | MD | Addiction (Substance Use Disorder) Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1316476800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1316476800000",
"number": "1356624019",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "501 SOUTH BURMA AVE.",
"city": "GILLETTE",
"state": "WY",
"postal_code": "827163426",
"telephone_number": "307-688-5000",
"fax_number": "307-688-5015"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "501 S BURMA AVE",
"city": "GILLETTE",
"state": "WY",
"postal_code": "827163426",
"telephone_number": "307-688-5000",
"fax_number": "307-688-5015"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HUCKINS",
"first_name": "MARTY",
"middle_name": "RAY",
"name_prefix": "Mr.",
"credential": "CAP, CCDC III, ICADC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2011-09-20",
"last_updated": "2011-09-20",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "WY",
"license": "052",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Gillette, WY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.