Active NPI
Bethany Gallant, LPC
- Professional Counselor
- New London, CT
National Provider Identifier
1053724930
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 002515
- Practice address
- 21 Montauk Ave
New London, CT 06320-4906 - Phone
- (860) 443-0530
- Fax
- (860) 443-0536
- NPI assigned
- Jun 9, 2014
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 002515 | CT | Primary |
Addresses
Primary practice location
21 Montauk Ave
New London, CT 06320-4906
Mailing address
20 Batterson Park Rd
Suite 300
Farmington, CT 06032-4502
Phone (860) 284-1177
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 |
|---|---|---|---|
| 002515 | CT | MD | Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Nafi Connecticut Inc. | Past | Accepting new patients |
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.
-
- Clinic/Center
- Hartford, CT
- NPI 1619258449
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1402272000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1402272000000",
"number": "1053724930",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "20 BATTERSON PARK RD",
"address_2": "SUITE 300",
"city": "FARMINGTON",
"state": "CT",
"postal_code": "060324502",
"telephone_number": "860-284-1177",
"fax_number": "860-284-1125"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "21 MONTAUK AVE",
"city": "NEW LONDON",
"state": "CT",
"postal_code": "063204906",
"telephone_number": "860-443-0530",
"fax_number": "860-443-0536"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GALLANT",
"first_name": "BETHANY",
"credential": "LPC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-06-09",
"last_updated": "2014-06-09",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "CT",
"license": "002515",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in New London, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.