Leo Gormley, CRADC

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

11787 Issued in MO

Practice address

6763 Page Ave # Mo
Saint Louis, MO 63133-1635

Phone

(314) 206-3910

NPI assigned

Nov 4, 2014

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1415059200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1647907200000",
    "number": "1811392798",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1430 OLIVE ST STE 400",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631032303",
            "telephone_number": "314-206-3700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6763 PAGE AVE # MO",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631331635",
            "telephone_number": "314-206-3910"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3248 Vandever Ave",
            "address_purpose": "LOCATION",
            "city": "Pekin",
            "state": "IL",
            "postal_code": "615546257",
            "country_code": "US",
            "telephone_number": "309-347-5579",
            "fax_number": "309-347-4264",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GORMLEY",
        "first_name": "LEO",
        "credential": "CRADC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-11-04",
        "last_updated": "2022-03-22",
        "certification_date": "2022-03-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "MO",
            "license": "11787",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kimberly Christine Gorman, PNP
• Lindsay Kathleen Gorman, D.M.D.
• Madison Gorman
• Carolyn Gormley, DPT
• Jessica Gormley, M.D.
• Megan Elise Gornet, MD
• Sabrina Gornish, MSOTR/L
• Geoffrey J. Gorse, M.D.
• April Gorski, MA, LPC
• Elizabeth Gorsuch, SLP

• Addiction (Substance Use Disorder) Counselor in Saint Louis, MO
• Providers in Saint Louis, MO by specialty
• Addiction (Substance Use Disorder) Counselor in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2022; 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.