Active NPI
David Gitlin
- Mental Health Counselor
- Quincy, FL
National Provider Identifier
1790101780
On this page
OIG exclusion record
The HHS Office of Inspector General’s List of Excluded Individuals/Entities (LEIE) contains a record with this NPI:
- Section 1128b(4) exclusion effective Apr 20, 2016.
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- PY4890
- Practice address
- 79 Lasalle Path
Quincy, FL 32351-5286 - Phone
- (850) 875-2422
- NPI assigned
- Mar 14, 2014
- 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 |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | PY4890 | FL | Primary |
Addresses
Primary practice location
79 Lasalle Path
Quincy, FL 32351-5286
Mailing address
79 Lasalle Path
Quincy, FL 32351-5286
Phone (850) 875-2422
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
- HHS exclusion list flag
- Flagged The directory lists this NPI on an HHS exclusion list.
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PY4890 | FL | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1394755200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1394755200000",
"number": "1790101780",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "79 LASALLE PATH",
"city": "QUINCY",
"state": "FL",
"postal_code": "323515286",
"telephone_number": "850-875-2422"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "79 LASALLE PATH",
"city": "QUINCY",
"state": "FL",
"postal_code": "323515286",
"telephone_number": "850-875-2422"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GITLIN",
"first_name": "DAVID",
"name_prefix": "Dr.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2014-03-14",
"last_updated": "2014-03-14",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "FL",
"license": "PY4890",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Quincy, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; OIG LEIE.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.