Individual provider Active NPI

Gabrielle Cummuta

  • Counselor
  • Aberdeen, WA
National Provider Identifier
1497227433
Registry record updated Sep 25, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
License
CG61099696 Issued in WA
Practice address
2700 Simpson Ave Ste 101
Aberdeen, WA 98520-4333
Phone
(360) 612-0012
Fax
(360) 532-0670
NPI assigned
Dec 31, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 25, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Technician 106S00000X
Counselor 101Y00000X CG61099696 WA Primary

Addresses

Primary practice location

2700 Simpson Ave Ste 101
Aberdeen, WA 98520-4333

Mailing address

PO Box 1847
Longview, WA 98632-8140
Phone (360) 423-0203

Other practice location 1

901 Caledonia St
LA Crosse, WI 54603-2616
Phone (608) 785-4100

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
CG61099696WAMDCounselor

Practice roles

OrganizationSpecialtyStatusNew patients
Columbia Wellness CurrentSince Apr 24, 2022 Accepting new patients

Locations

2700 Simpson Ave
Ste 101
Aberdeen, WA 98520
Phone (360) 612-0012

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1546214400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600992000000",
    "number": "1497227433",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1847",
            "city": "LONGVIEW",
            "state": "WA",
            "postal_code": "986328140",
            "telephone_number": "360-423-0203",
            "fax_number": "360-577-0187"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2700 SIMPSON AVE STE 101",
            "city": "ABERDEEN",
            "state": "WA",
            "postal_code": "985204333",
            "telephone_number": "360-612-0012",
            "fax_number": "360-532-0670"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "901 Caledonia St",
            "address_purpose": "LOCATION",
            "city": "LA Crosse",
            "state": "WI",
            "postal_code": "546032616",
            "country_code": "US",
            "telephone_number": "608-785-4100",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CUMMUTA",
        "first_name": "GABRIELLE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-12-31",
        "last_updated": "2020-09-25",
        "certification_date": "2020-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "WA",
            "license": "CG61099696",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Aberdeen, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2020; 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.