Individual provider Active NPI

Anita R Gaylor, LPCC, CADC

  • Mental Health Counselor
  • Hazard, KY
National Provider Identifier
1174740989
Registry record updated Aug 5, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
1448 Issued in KY
Practice address
115 Rockwood LN
Hazard, KY 41701-9415
Phone
(606) 436-5761
Fax
(606) 436-5797
NPI assigned
Apr 20, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 5, 2014

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 0766 KY
Mental Health Counselor 101YM0800X 0500 KY
Mental Health Counselor 101YM0800X 1448 KY Primary

Addresses

Primary practice location

115 Rockwood LN
Hazard, KY 41701-9415

Mailing address

115 Rockwood LN
Hazard, KY 41701-9415
Phone (606) 436-5761

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

LicenseStateTypeSpecialty
0766KYMDAddiction (Substance Use Disorder) Counselor
0500KYMDMarriage & Family Therapist
1448KYMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1177027200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1407196800000",
    "number": "1174740989",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "115 ROCKWOOD LN",
            "city": "HAZARD",
            "state": "KY",
            "postal_code": "417019415",
            "telephone_number": "606-436-5761",
            "fax_number": "606-436-5797"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 ROCKWOOD LN",
            "city": "HAZARD",
            "state": "KY",
            "postal_code": "417019415",
            "telephone_number": "606-436-5761",
            "fax_number": "606-436-5797"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAYLOR",
        "first_name": "ANITA",
        "middle_name": "R",
        "credential": "LPCC, CADC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-20",
        "last_updated": "2014-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "KY",
            "license": "0766",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "KY",
            "license": "0500",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "KY",
            "license": "1448",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hazard, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 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.

Verify at the official NPI Registry.