1609975168 NPI number — GARY F YOUSSEF MS, IMFT

Table of content: GARY F YOUSSEF MS, IMFT (NPI 1609975168)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1609975168 NPI number — GARY F YOUSSEF MS, IMFT

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
YOUSSEF
Provider First Name:
GARY
Provider Middle Name:
F
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MS, IMFT
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1609975168
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/01/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
4417 WILLYS PKWY
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
TOLEDO
Provider Business Mailing Address State Name:
OH
Provider Business Mailing Address Postal Code:
43612-2131
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
567-298-1539
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4417 WILLYS PKWY
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
TOLEDO
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
43612-2131
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
567-298-1539
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
09/21/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 106H00000X , with the licence number:  45456 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 106H00000X , with the licence number: F.2500504 , registered in the state of OH ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 1609975168 , issued by the state of ( CA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 45456 . This is a "CALIFORNIA BOARD OF BEHAVIORAL SCIENCES" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".
  • Identifier: F.2500504 . This is a "OHIO COUNSELOR, SOCIAL WORKER AND MARRIAGE AND FAMILY THERAPIST BOARD" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".




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