GREGORY JOHN WIGHTMAN (NPI# 1073672275) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1073672275 |
| Entity Type | Individual |
| Full Name | GREGORY JOHN WIGHTMAN |
| Credential | L.P.C.C. SUPV. |
| Practice Address |
2611 Wayne Ave Building #66 Dayton OH 45420-1833 |
| Mailing Address |
30 E Broad St 11th Floor Columbus OH 43215-3414 |
| Practice Telephone | 9372580440 |
| Practice Fax Number | 9372586235 |
| Mailing Telephone | 6144666583 |
| Mailing Fax Number | 6149953268 |
| Enumeration Date | 2006-12-06 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101Y00000X | Counselor | E0000394 SUPV | OH | Behavioral Health & Social Service Providers |
| Street Address |
2611 WAYNE AVE BUILDING #66 |
| City | DAYTON |
| State | OH |
| Zip Code | 45420-1833 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750350658 | State of Ohio Department of Mental Health | Case Management | 2611 Wayne Ave, Bldg #66, Dayton, OH 45420-1833 | 2006-03-15 |
| 1053926246 | Nikkol Michelle Ferguson | Licensed Practical Nurse | 2611 Wayne Ave, Dayton, OH 45420-1833 | 2020-09-14 |
| 1457963878 | Jessica Lynn Phillips | Licensed Practical Nurse | 2611 Wayne Ave, Dayton, OH 45420-1833 | 2020-08-18 |
| 1417569005 | Michael Baker | Licensed Practical Nurse | 2611 Wayne Ave, Dayton, OH 45420-1833 | 2020-08-17 |
| 1629611421 | Alexus Sanders | Case Manager/Care Coordinator | 2611 Wayne Ave, Dayton, OH 45420-1833 | 2019-10-24 |
| 1144875386 | Kathleen Margaret Thompson | Registered Nurse | 2611 Wayne Ave, Dayton, OH 45420-1833 | 2019-08-05 |
| 1205498433 | Terry Shawn Wilson | Counselor | 2611 Wayne Ave, Dayton, OH 45420-1833 | 2019-07-09 |
| 1528629789 | Quinton A Osborne | Counselor | 2611 Wayne Ave, Dayton, OH 45420-1833 | 2019-06-27 |
| 1457827677 | Kellie Jean Morrissey | Case Manager/Care Coordinator | 2611 Wayne Ave, Dayton, OH 45420-1833 | 2018-10-15 |
| 1083196018 | Charles Robert Wick | Case Manager/Care Coordinator | 2611 Wayne Ave, Dayton, OH 45420-1833 | 2018-09-06 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841824547 | Erica Brooke Harris | Chore Provider | 2526 Revere Ave, Apt 10, Dayton, OH 45420 | 2020-03-03 |
| 1932626611 | Christine Catherine Kukla | Counselor | 3280 Woodman Drive, Kettering, OH 45420 | 2017-08-24 |
| 1528502531 | Melanie Renee Gecili | Social Worker | 12 Earhart Place, Dayton, OH 45420 | 2016-12-09 |
| 1629433073 | Morgan Pridemore | Counselor | 2754 S Smithville Rd, Dayton, OH 45420 | 2015-12-29 |
| 1265807515 | Garry Brown | Counselor | 2611 Wayne Ave Bldg 61, Dayton, OH 45420 | 2015-12-10 |
| 1285046839 | Gina Katherine Howenstine | Registered Nurse | 3000 Glengarry Dr., Kettering, OH 45420 | 2014-05-29 |
| 1205260007 | Jo Ellen Perbix Kuzila | Speech-Language Pathologist | 1968-f Woodman Center Drive, Dayton, OH 45420 | 2013-08-28 |
| 1245511575 | Honey Nicole Strong | Licensed Practical Nurse | 1036 Mendota Ct, Kettering, OH 45420 | 2011-08-31 |
| 1043358096 | Cleanne Cass | Family Medicine | 324 Wilmington Avenue, Dayton, OH 45420 | 2007-02-02 |
| 1104981919 | Timothy Harold Farney | Dentist | 2297 Patterson Road, Kettering, OH 45420 | 2006-12-22 |
| Find all providers in zip 45420 | ||||
| Taxonomy Code | 101Y00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master’s degree and clinical experience and supervision for licensure or certification. |
| Notes: Sources: Abridged from definitions provided by the National Board of Certified Counselors and the American Association of Pastoral Counselors. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962045021 | Kenyatta Williams | Counselor | 4218 Crownwood Ave, Dayton, OH 45415-1402 | 2019-10-22 |
| 1033752241 | Holly Dawn Karban | Counselor | 131 N Ludlow St Ste 258, Dayton, OH 45402-1148 | 2019-10-21 |
| 1447717590 | Cahana Dawson-terry | Counselor | 1245 Wabash Ave, Dayton, OH 45405-3956 | 2019-02-25 |
| 1982102919 | Five Rivers Health Centers | Counselor | 3908 Wilmington Pike, Dayton, OH 45429-5053 | 2018-01-24 |
| 1619491263 | Jessica C Tupa | Counselor | 425 N Findlay St, Dayton, OH 45404-2203 | 2017-07-26 |
| 1568811016 | Rebecca Haney | Counselor | 11 W Monument Ave Ste 310, Dayton, OH 45402-1285 | 2016-06-06 |
| 1841648441 | Susan Michel Ashtianie | Counselor | 14496 Triadelphia Mill Rd, Dayton, MD 21036-1220 | 2016-05-25 |
| 1629433073 | Morgan Pridemore | Counselor | 2754 S Smithville Rd, Dayton, OH 45420 | 2015-12-29 |
| 1912393877 | Holli Burns | Counselor | 2745 S Smithville Rd # 8232, Dayton, OH 45420-2668 | 2015-04-07 |
| 1497153340 | Brianna T. Abram | Counselor | 1110 Webster St, Dayton, OH 45404-1556 | 2014-12-09 |
| Find all providers in DAYTON | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.