Gordy J Whitcomb

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

436 Issued in NE

Legal business name

GORDY J WHITCOMB

Practice address

748 N Main St
Fremont, NE 68025-5004

Phone

(402) 374-0245

Fax

(402) 564-7735

NPI assigned

Dec 7, 2016

Last updated

Dec 7, 2016By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Gordy J Whitcomf, LMHP LADC

Title

Owner/Operator

Phone

(402) 374-0245

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Gordy J Whitcomb, LMHP LADAC

  • Addiction (Substance Use Disorder) Counselor
  • Fremont, NE
  • NPI 1598891624

  Mental Health

  NPD (past)

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

{
    "created_epoch": "1481068800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1481068800000",
    "number": "1972047074",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1481 COUNTY ROAD 29",
            "city": "TEKAMAH",
            "state": "NE",
            "postal_code": "680615030",
            "telephone_number": "402-374-0245",
            "fax_number": "402-564-7735"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "748 N MAIN ST",
            "city": "FREMONT",
            "state": "NE",
            "postal_code": "680255004",
            "telephone_number": "402-374-0245",
            "fax_number": "402-564-7735"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GORDY J WHITCOMB",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-12-07",
        "last_updated": "2016-12-07",
        "status": "A",
        "authorized_official_last_name": "WHITCOMF",
        "authorized_official_first_name": "GORDY",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OWNER/OPERATOR",
        "authorized_official_telephone_number": "402-374-0245",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "LMHP LADC"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": "NE",
            "license": "436",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Mental Health Counselor in Fremont, NE
• Providers in Fremont, NE by specialty
• Mental Health Counselor in Nebraska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2016; 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.