NPIMap

Individual provider Active NPI

Dustin Hayes Gardner, CG60997225 - AAC

  • Counselor
  • Centralia, WA
National Provider Identifier
1861026031
Registry record updated Nov 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
License
CG60997225 Issued in WA
Practice address
3510 Steelhammer Dr
Centralia, WA 98531-4551
Phone
(360) 623-8020
Fax
(360) 623-1072
NPI assigned
Feb 26, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 27, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X CG60997225 WA Primary

Addresses

Primary practice location

3510 Steelhammer Dr
Centralia, WA 98531-4551

Mailing address

3510 Steelhammer Dr
Centralia, WA 98531-4551
Phone (360) 623-8020

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address gardnerd@cascadementalhealth.org Direct Cascade Evaluation and Treatment Center

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

LicenseStateTypeSpecialty
CG60997225WAMDCounselor

Practice roles

OrganizationSpecialtyStatusNew patients
Cascade Community Healthcare PastSince Mar 1, 2020 Accepting new patients
Cascade Evaluation and Treatment Center PastSince Mar 1, 2020 Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1582675200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701043200000",
    "number": "1861026031",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3510 STEELHAMMER DR",
            "city": "CENTRALIA",
            "state": "WA",
            "postal_code": "985314551",
            "telephone_number": "360-623-8020",
            "fax_number": "360-623-1072"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3510 STEELHAMMER DR",
            "city": "CENTRALIA",
            "state": "WA",
            "postal_code": "985314551",
            "telephone_number": "360-623-8020",
            "fax_number": "360-623-1072"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GARDNER",
        "first_name": "DUSTIN",
        "middle_name": "HAYES",
        "credential": "CG60997225 - AAC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-02-26",
        "last_updated": "2023-11-27",
        "certification_date": "2020-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "WA",
            "license": "CG60997225",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "gardnerd@cascadementalhealth.org",
            "affiliation": "Y",
            "endpointDescription": "direct email",
            "affiliationName": "Cascade Evaluation and Treatment Center",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "messaging",
            "address_1": "3510 Steelhammer Dr",
            "city": "Centralia",
            "state": "WA",
            "country_code": "US",
            "postal_code": "985314551",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Centralia, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 2023; 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.