Active NPI
Erin Elizabeth Gdovin, PLPC
- Professional Counselor
- Nixa, MO
National Provider Identifier
1639719487
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 2019047936
- Practice address
- 202 S West St Ste 4
Nixa, MO 65714-6902 - Phone
- (417) 494-5031
- NPI assigned
- Jan 9, 2020
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 2019047936 | MO | Primary |
Addresses
Primary practice location
202 S West St Ste 4
Nixa, MO 65714-6902
Mailing address
1440 State Highway 248 Ste Q
Branson, MO 65616-9257
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 |
|---|---|---|---|
| 2019047936 | MO | MD | Professional Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Nixa Behavioral Services, LLC | Professional | Past | Accepting new patients |
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": "1578528000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1578528000000",
"number": "1639719487",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1440 STATE HIGHWAY 248 STE Q",
"city": "BRANSON",
"state": "MO",
"postal_code": "656169257"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "202 S WEST ST STE 4",
"city": "NIXA",
"state": "MO",
"postal_code": "657146902",
"telephone_number": "417-494-5031"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GDOVIN",
"first_name": "ERIN",
"middle_name": "ELIZABETH",
"credential": "PLPC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-01-09",
"last_updated": "2020-01-09",
"certification_date": "2020-01-09",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Counselor, Professional",
"state": "MO",
"license": "2019047936",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Nixa, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 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.