Octavia Alicia Gallon, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

LPC-1899 Issued in WY

Practice address

2232 Dell Range Blvd Ste 270
Cheyenne, WY 82009-4980

Phone

(307) 222-9015

NPI assigned

Jan 18, 2018

Last updated

Nov 5, 2020By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in CO, AZ, FL3 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 3

Specialty

Mental Health Counselor

Education

Other, 2017

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• G Force Consulting LLC

  • Mental Health Counselor
  • Cheyenne, WY
  • NPI 1427658350
  NPD Authorized official
• Grow Healthcare Group PA

  • Mental Health Counselor
  • Miami, FL
  • NPI 1245845932

  AZ, CO

  Medicare reassignment

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

{
    "created_epoch": "1516233600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1604534400000",
    "number": "1851809388",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2232 DELL RANGE BLVD STE 270",
            "city": "CHEYENNE",
            "state": "WY",
            "postal_code": "820094980",
            "telephone_number": "307-222-9015"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2232 DELL RANGE BLVD STE 270",
            "city": "CHEYENNE",
            "state": "WY",
            "postal_code": "820094980",
            "telephone_number": "307-222-9015"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GALLON",
        "first_name": "OCTAVIA",
        "middle_name": "ALICIA",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-01-18",
        "last_updated": "2020-11-05",
        "certification_date": "2020-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "WY",
            "license": "PPC-1048",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "WY",
            "license": "LPC-1899",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "148935600",
            "state": "WY"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "https://www.bestnotes.com/",
            "affiliation": "N",
            "endpointDescription": "EHR",
            "address_1": "2232 Dell Range Blvd Ste 270",
            "city": "Cheyenne",
            "state": "WY",
            "country_code": "US",
            "postal_code": "820094980",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Gallardo Health Services LLC
• Nikki Chantelle Gallardo, LCSW
• Emily Jean Gallegos, MD
• Nicholas James Gallinger, PHARMD
• Natasha Sue Gallizzi, PHARM.D.
• Hetti K Galloway
• Kristine Galloway
• Jared Gamet, M.D.
• Tammy Lou Gamino
• Sherri Gantek, MS, RD

• Professional Counselor in Cheyenne, WY
• Providers in Cheyenne, WY by specialty
• Professional Counselor in Wyoming

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.