Keisha Lakia Gamble

Primary specialty

CounselorTaxonomy code 101Y00000X

Practice address

895 Blue Hill Ave
Dorchester, MA 02124-2902

Phone

(617) 506-8188

Fax

(617) 297-5039

NPI assigned

Mar 22, 2019

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 3

Electronic endpoints 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1553212800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1553212800000",
    "number": "1083174254",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "133B LUCERNE ST",
            "city": "DORCHESTER",
            "state": "MA",
            "postal_code": "021243923",
            "telephone_number": "617-593-1260"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "895 BLUE HILL AVE",
            "city": "DORCHESTER",
            "state": "MA",
            "postal_code": "021242902",
            "telephone_number": "617-506-8188",
            "fax_number": "617-297-5039"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAMBLE",
        "first_name": "KEISHA",
        "middle_name": "LAKIA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-03-22",
        "last_updated": "2019-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NONE",
            "identifier": "0000",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NONE",
            "identifier": "0000",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NONE",
            "identifier": "NONE",
            "state": null
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "email",
            "affiliation": "N",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "documents",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "fax",
            "address_1": "895 Blue Hill Ave",
            "city": "Dorchester",
            "state": "MA",
            "country_code": "US",
            "postal_code": "021242902",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "employer",
            "affiliation": "N",
            "endpointDescription": "employer",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "documents",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "mental health agency",
            "address_1": "895 Blue Hill Ave",
            "city": "Dorchester",
            "state": "MA",
            "country_code": "US",
            "postal_code": "021242902",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Heather Elizabeth Galeotalanza, RN
• Kimberly Gallaugher
• Amy Rae Gallman, RN
• Rebecca Gallo
• Cristy Lynn Galvin, CNP
• Jova Gamboa, M.ED
• Keiani Garcia Santos Gomes, OTR
• Karem Garcia
• Christopher John Garden
• Michelle Garland

• Counselor in Dorchester, MA
• Providers in Dorchester, MA by specialty
• Counselor in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.