Gary Wayne Osborne, LPC, MHSP

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

LPC583 Issued in TN

Practice address

1629 E Main St
Humboldt, TN 38343

Phone

(731) 618-0266

Fax

(731) 824-5398

NPI assigned

Oct 3, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in TN

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 1

Specialty

Mental Health Counselor

Education

Liberty Univ College of Osteopathic Medicine, 1999

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

SDG Primary and Immediate Care LLCGroup PAC ID 2264758689, 5 clinicians

Humboldt Family Walk-in Clinic LLCGroup PAC ID 3072899434, 6 clinicians

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 and National Provider Directory roles.

• SDG Primary and Immediate Care LLC

  • Rural Health Clinic/Center
  • Halls, TN
  • NPI 1225437585
  Medicare reassignment Care Compare group NPD
• Better Health Family Clinic Inc

  • Rural Health Clinic/Center
  • Dyersburg, TN
  • NPI 1982580619
  Medicare reassignment NPD
• Humboldt Family Walk-in Clinic LLC

  • Rural Health Clinic/Center
  • Humboldt, TN
  • NPI 1881135895
  Care Compare group
• Dyersburg Family Walk-in Clinic LLC

  • Rural Health Clinic/Center
  • Dyersburg, TN
  • NPI 1174712780
  NPD (past)

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

{
    "created_epoch": "1159833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732060800000",
    "number": "1891880209",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "113 ROLLING OAKS DR",
            "city": "HUMBOLDT",
            "state": "TN",
            "postal_code": "383438586",
            "telephone_number": "731-618-0055",
            "fax_number": "731-824-5398"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1629 E MAIN ST",
            "city": "HUMBOLDT",
            "state": "TN",
            "postal_code": "38343",
            "telephone_number": "731-618-0266",
            "fax_number": "731-824-5398"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "201 S Front St",
            "address_purpose": "LOCATION",
            "city": "Halls",
            "state": "TN",
            "postal_code": "380401547",
            "country_code": "US",
            "telephone_number": "731-836-5617",
            "fax_number": "731-836-5284",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "OSBORNE",
        "first_name": "GARY",
        "middle_name": "WAYNE",
        "name_prefix": "Dr.",
        "credential": "LPC, MHSP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-03",
        "last_updated": "2024-11-20",
        "certification_date": "2024-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "TN",
            "license": "LPC583",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "3102484",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "7017081",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAGELLAN HEALTH SERVICES",
            "identifier": "229202000",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Mental Health Counselor in Humboldt, TN
• Providers in Humboldt, TN by specialty
• Mental Health Counselor in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2024; 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.