Individual provider Active NPI

Elisa L. Gambill, LPC

  • Counselor
  • Blue Ash, OH
National Provider Identifier
1578070918
Registry record updated Jan 23, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
License
C.1901681 Issued in OH
Practice address
10921 Reed Hartman Hwy Ste 133
Blue Ash, OH 45242-2851
Phone
(513) 984-9838
NPI assigned
Jan 8, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 23, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X C.1901681 OH Primary

Addresses

Primary practice location

10921 Reed Hartman Hwy Ste 133
Blue Ash, OH 45242-2851

Mailing address

10921 Reed Hartman Hwy Ste 133
Blue Ash, OH 45242-2851

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
C.1901681OHMDCounselor

Practice roles

OrganizationSpecialtyStatusNew patients
Scioto Paint Valley Mental Health Center Past Accepting new patients

Interoperability endpoints

  • FHIR API: https://api.qualifacts.org/api/fhir/spvmhc/r4/

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": "1515369600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1548201600000",
    "number": "1578070918",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10921 REED HARTMAN HWY STE 133",
            "city": "BLUE ASH",
            "state": "OH",
            "postal_code": "452422851"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10921 REED HARTMAN HWY STE 133",
            "city": "BLUE ASH",
            "state": "OH",
            "postal_code": "452422851",
            "telephone_number": "513-984-9838"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAMBILL",
        "first_name": "ELISA",
        "middle_name": "L.",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-01-08",
        "last_updated": "2019-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "OH",
            "license": "C.1901681",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Blue Ash, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2019; 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.