Active NPI
Judy Gamble
- Mental Health Counselor
- Fremont, OH
National Provider Identifier
1912418583
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- Practice address
- 675 Bartson Rd
Fremont, OH 43420-9672 - Phone
- (419) 332-5524
- NPI assigned
- Oct 23, 2017
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | CDCA.180554 | OH | |
| Mental Health Counselor | 101YM0800X | OH | Primary |
Addresses
Primary practice location
675 Bartson Rd
Fremont, OH 43420-9672
Mailing address
1925 Hayes Ave
Sandusky, OH 44870-4737
Phone (419) 557-5177
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 |
|---|---|---|---|
| CDCA.180554 | OH | MD | Addiction (Substance Use Disorder) Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1508716800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1651536000000",
"number": "1912418583",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1925 HAYES AVE",
"city": "SANDUSKY",
"state": "OH",
"postal_code": "448704737",
"telephone_number": "419-557-5177"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "675 BARTSON RD",
"city": "FREMONT",
"state": "OH",
"postal_code": "434209672",
"telephone_number": "419-332-5524"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GAMBLE",
"first_name": "JUDY",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2017-10-23",
"last_updated": "2022-05-03",
"certification_date": "2022-05-03",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "OH",
"license": "CDCA.180554",
"primary": false
},
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "OH",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fremont, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 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.