Type 1 · Individual ✓ Active NPI ✓ Valid NPI checksum

Theodore Gongola

Counselor in Russellville, AR · enumerated 2012.

Data current as of Jul 13, 2026 · sourced from CMS NPPES

National Provider Identifier

1053656108

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Registry record

Entity type Individual (Type 1)

Name Theodore Gongola

Sex Male

Practice address 3205 W Main St, Russellville, AR, 72801

Phone (479) 967-4673

Fax (479) 967-7140

Enumeration date Nov 30, 2012

Last updated in NPPES Nov 30, 2012

Taxonomy & licenses

101Y00000X Counselor Behavioral Health & Social Service Providers Primary

What is an NPI number?

A National Provider Identifier (NPI) is a unique 10-digit number that CMS assigns to every U.S. healthcare provider and organization under HIPAA. Type 1 NPIs identify individual providers; Type 2 NPIs identify organizations. The NPI appears on insurance claims, prescriptions, and credentialing paperwork, and never changes, even if the provider moves or changes specialty.

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Frequently asked questions

What is the NPI number for Theodore Gongola?

The National Provider Identifier (NPI) for Theodore Gongola is 1053656108, a Type 1 (individual) record in the CMS NPPES registry.

Where does Theodore Gongola practice?

The practice location on file with NPPES is in Russellville, AR. Providers can have multiple locations; NPPES lists the primary practice address.

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Source: CMS NPPES (public data). Snapshot 2026-07-13. Provider record last updated 2012-11-30.