Active NPI
Daniel Gaxiola
- Mental Health Counselor
- Bend, OR
National Provider Identifier
1760984082
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- Practice address
- 2577 NE Courtney Dr
Bend, OR 97701-7752 - Phone
- (541) 322-7500
- Fax
- (541) 322-7565
- NPI assigned
- Mar 2, 2018
- Last updated
- May 16, 2019
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Behavior Technician | 106S00000X | |||
| Mental Health Counselor | 101YM0800X | OR | Primary |
Addresses
Primary practice location
2577 NE Courtney Dr
Bend, OR 97701-7752
Mailing address
PO Box 1432
Bend, OR 97709-1432
Other practice location 1
19800 Village Office Ct Ste 104
Bend, OR 97702-1813
Phone (541) 480-2570
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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Cascade Behavioral Intervention, LLC | 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1519948800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1557964800000",
"number": "1760984082",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1432",
"city": "BEND",
"state": "OR",
"postal_code": "977091432"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2577 NE COURTNEY DR",
"city": "BEND",
"state": "OR",
"postal_code": "977017752",
"telephone_number": "541-322-7500",
"fax_number": "541-322-7565"
}
],
"practiceLocations": [
{
"address_1": "19800 Village Office Ct Ste 104",
"address_purpose": "LOCATION",
"city": "Bend",
"state": "OR",
"postal_code": "977021813",
"country_code": "US",
"telephone_number": "541-480-2570",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "GAXIOLA",
"first_name": "DANIEL",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2018-03-02",
"last_updated": "2019-05-16",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": null,
"license": null,
"primary": false
},
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "OR",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bend, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 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.