Active NPI
Deidra Aubrey Gwyther
- Mental Health Counselor
- Springfield, OR
National Provider Identifier
1962669218
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- Practice address
- 175 W B St Ste I
Springfield, OR 97477-4575 - Phone
- (541) 988-1025
- Fax
- (541) 844-1051
- NPI assigned
- May 22, 2008
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Technician | 106S00000X | |||
| Mental Health Counselor | 101YM0800X | Primary |
Addresses
Primary practice location
175 W B St Ste I
Springfield, OR 97477-4575
Mailing address
175 W B St Ste I
Springfield, OR 97477-4575
Phone (541) 988-1025
Other practice location 1
27777 Inkster Rd Ste 100
Farmington Hills, MI 48334-5326
Phone (248) 436-4400
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 241382 | Medicaid | OR |
Other names 1
- Miss Debra Lynn Smith
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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Safe, Incorporated | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Community/Behavioral Health Agency
- Springfield, OR
- NPI 1902937717
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1211414400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1572825600000",
"number": "1962669218",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "175 W B ST STE I",
"city": "SPRINGFIELD",
"state": "OR",
"postal_code": "974774575",
"telephone_number": "541-988-1025",
"fax_number": "541-844-1051"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "175 W B ST STE I",
"city": "SPRINGFIELD",
"state": "OR",
"postal_code": "974774575",
"telephone_number": "541-988-1025",
"fax_number": "541-844-1051"
}
],
"practiceLocations": [
{
"address_1": "27777 Inkster Rd Ste 100",
"address_purpose": "LOCATION",
"city": "Farmington Hills",
"state": "MI",
"postal_code": "483345326",
"country_code": "US",
"telephone_number": "248-436-4400",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "GWYTHER",
"first_name": "DEIDRA",
"middle_name": "AUBREY",
"name_prefix": "Ms.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-05-22",
"last_updated": "2019-11-04",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": null,
"license": null,
"primary": false
},
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "241382",
"state": "OR"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "DEBRA",
"last_name": "SMITH",
"middle_name": "LYNN",
"prefix": "MISS",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Springfield, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.