Individual provider Active NPI

Manuel Occhiogrosso, LMHC

  • Mental Health Counselor
  • Gig Harbor, WA
National Provider Identifier
1972778686
Registry record updated Jan 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
MH 8662 Issued in FL
Practice address
3309 56TH St Ste 101
Gig Harbor, WA 98335-8580
Phone
(360) 360-0334
Fax
(360) 443-2365
NPI assigned
Apr 23, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 27, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X MH8662 FL
Professional Counselor 101YP2500X 216170
Mental Health Counselor 101YM0800X MH 8662 FL Primary

Addresses

Primary practice location

3309 56TH St Ste 101
Gig Harbor, WA 98335-8580

Mailing address

7348 Baltray PL SW
Port Orchard, WA 98367-7691
Phone (360) 360-0334

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
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

Enrollment IDStateProvider typePAC IDDetails
I20240509000188 WA Practitioner - Mental Health Counselor 6901247063 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Mindscape CounselingGroup PAC ID 9638517360, 2 clinicians

Practice addresses (Care Compare)

3309 56TH St
Suite 101
Gig Harbor, WA 98335-8580
Phone (360) 360-0334

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
MH8662FLMDAddiction (Substance Use Disorder) Counselor
MH 8662FLMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Mindscape Counseling Addiction (Substance Use Disorder) CurrentSince Jan 1, 2021 Accepting new patients

Locations

3309 56th St
Ste 101
Gig Harbor, WA 98335
Phone (253) 851-3141

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.

NPI Registry JSON

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

{
    "created_epoch": "1208908800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674777600000",
    "number": "1972778686",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7348 BALTRAY PL SW",
            "city": "PORT ORCHARD",
            "state": "WA",
            "postal_code": "983677691",
            "telephone_number": "360-360-0334",
            "fax_number": "360-598-0039"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3309 56TH ST STE 101",
            "city": "GIG HARBOR",
            "state": "WA",
            "postal_code": "983358580",
            "telephone_number": "360-360-0334",
            "fax_number": "360-443-2365"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OCCHIOGROSSO",
        "first_name": "MANUEL",
        "credential": "LMHC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-04-23",
        "last_updated": "2023-01-27",
        "certification_date": "2023-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "FL",
            "license": "MH8662",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": null,
            "license": "216170",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "MH 8662",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gig Harbor, WA

Sources for this page

Verify at the official NPI Registry.