Active NPI
Timothy Marvin Gregory, LADC, LPCC, CAMS-II
- Mental Health Counselor
- Richfield, MN
National Provider Identifier
1518599323
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 2269
- Practice address
- 308 E 78TH St
Richfield, MN 55423-4315 - Phone
- (952) 956-3162
- NPI assigned
- Feb 10, 2020
- Last updated
- Feb 10, 2020
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 304316 | MN | |
| Mental Health Counselor | 101YM0800X | 2269 | MN | Primary |
Addresses
Primary practice location
308 E 78TH St
Richfield, MN 55423-4315
Mailing address
308 E 78TH St
Richfield, MN 55423-4315
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 |
|---|---|---|---|
| 304316 | MN | MD | Addiction (Substance Use Disorder) Counselor |
| 2269 | MN | MD | Certified Respiratory Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1581292800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1581292800000",
"number": "1518599323",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "308 E 78TH ST",
"city": "RICHFIELD",
"state": "MN",
"postal_code": "554234315"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "308 E 78TH ST",
"city": "RICHFIELD",
"state": "MN",
"postal_code": "554234315",
"telephone_number": "952-956-3162"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GREGORY",
"first_name": "TIMOTHY",
"middle_name": "MARVIN",
"name_prefix": "Mr.",
"credential": "LADC, LPCC, CAMS-II",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2020-02-10",
"last_updated": "2020-02-10",
"certification_date": "2020-02-10",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "MN",
"license": "304316",
"primary": false
},
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "MN",
"license": "2269",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Richfield, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 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.