Active NPI
Gavin Elijah McConnell, LCPC
- Mental Health Counselor
- Oakland, MD
National Provider Identifier
1053167262
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- LC18324
- Practice address
- 1025 Memorial Dr
Oakland, MD 21550-4343 - Phone
- (301) 334-7680
- Fax
- (301) 334-7681
- NPI assigned
- Apr 29, 2024
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | LC18324 | MD | Primary |
Addresses
Primary practice location
1025 Memorial Dr
Oakland, MD 21550-4343
Mailing address
PO Box 158
Grantsville, MD 21536-0158
Phone (240) 956-9650
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LGP15013 | MD | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1714348800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1786665600000",
"number": "1053167262",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 158",
"city": "GRANTSVILLE",
"state": "MD",
"postal_code": "215360158",
"telephone_number": "240-956-9650"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1025 MEMORIAL DR",
"city": "OAKLAND",
"state": "MD",
"postal_code": "215504343",
"telephone_number": "301-334-7680",
"fax_number": "301-334-7681"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCCONNELL",
"first_name": "GAVIN",
"middle_name": "ELIJAH",
"name_prefix": "Mr.",
"credential": "LCPC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2024-04-29",
"last_updated": "2026-08-14",
"certification_date": "2026-08-14",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "MD",
"license": "LC18324",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Oakland, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.