Active NPI
Gwyn Denise Kingery, QMHA
- Mental Health Counselor
- Newport, OR
National Provider Identifier
1861023947
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- MHACBO
- Practice address
- 51 SW Lee St
Newport, OR 97365-3823 - Phone
- (541) 574-5963
- Fax
- (541) 265-0606
- NPI assigned
- Jan 28, 2020
- Sex
- Female
- 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 | MHACBO | OR | Primary |
Addresses
Primary practice location
51 SW Lee St
Newport, OR 97365-3823
Mailing address
36 SW Nye St
Newport, OR 97365-3821
Phone (541) 265-4179
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 |
|---|---|---|---|
| MHACBO | OR | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1580169600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1580169600000",
"number": "1861023947",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "36 SW NYE ST",
"city": "NEWPORT",
"state": "OR",
"postal_code": "973653821",
"telephone_number": "541-265-4179",
"fax_number": "541-265-0606"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "51 SW LEE ST",
"city": "NEWPORT",
"state": "OR",
"postal_code": "973653823",
"telephone_number": "541-574-5963",
"fax_number": "541-265-0606"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KINGERY",
"first_name": "GWYN",
"middle_name": "DENISE",
"credential": "QMHA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-01-28",
"last_updated": "2020-01-28",
"certification_date": "2020-01-28",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "OR",
"license": "MHACBO",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Newport, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.