Active NPI
Martin Gaudiose, LPCC-S
- Professional Counselor
- Marion, OH
National Provider Identifier
1770018764
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- E1509
- Practice address
- 320 Executive Dr
Marion, OH 43302-6310 - Phone
- (740) 387-5210
- Fax
- (740) 383-3472
- NPI assigned
- Apr 27, 2017
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | E1509 | OH | Primary |
Addresses
Primary practice location
320 Executive Dr
Marion, OH 43302-6310
Mailing address
320 Executive Dr
Marion, OH 43302-6310
Phone (740) 387-5210
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 |
|---|---|---|---|
| E1509 | OH | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1493251200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1493251200000",
"number": "1770018764",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "320 EXECUTIVE DR",
"city": "MARION",
"state": "OH",
"postal_code": "433026310",
"telephone_number": "740-387-5210",
"fax_number": "740-383-3472"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "320 EXECUTIVE DR",
"city": "MARION",
"state": "OH",
"postal_code": "433026310",
"telephone_number": "740-387-5210",
"fax_number": "740-383-3472"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GAUDIOSE",
"first_name": "MARTIN",
"name_prefix": "Mr.",
"credential": "LPCC-S",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2017-04-27",
"last_updated": "2017-04-27",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "OH",
"license": "E1509",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Marion, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.