Individual provider Active NPI

Donald Joseph Gauck, LICDC-CS

  • Addiction (Substance Use Disorder) Counselor
  • Cincinnati, OH
National Provider Identifier
1376063339
Registry record updated Jun 21, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
954218 Issued in OH
Practice address
830 Ezzard Charles Dr
Cincinnati, OH 45214-2525
Phone
(513) 381-6672
Fax
(513) 381-6672
NPI assigned
Jun 21, 2017
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 21, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101YA0400X 954218 OH Primary

Addresses

Primary practice location

830 Ezzard Charles Dr
Cincinnati, OH 45214-2525

Mailing address

2622 Morrow PL
Cincinnati, OH 45204-2405
Phone (513) 768-2942

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

LicenseStateTypeSpecialty
954218OHMDAddiction (Substance Use Disorder) Counselor

NPI Registry JSON

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

{
    "created_epoch": "1498003200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1498003200000",
    "number": "1376063339",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2622 MORROW PL",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452042405",
            "telephone_number": "513-768-2942"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "830 EZZARD CHARLES DR",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452142525",
            "telephone_number": "513-381-6672",
            "fax_number": "513-381-6672"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAUCK",
        "first_name": "DONALD",
        "middle_name": "JOSEPH",
        "credential": "LICDC-CS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-06-21",
        "last_updated": "2017-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "OH",
            "license": "954218",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cincinnati, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2017; 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.