Logan Jade Gasko, MA

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

6301018085 Issued in MI

Practice address

1777 Axtell Dr Ste 100
Troy, MI 48084-4400

Phone

(248) 613-5377

NPI assigned

Sep 17, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

State licenses

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

{
    "created_epoch": "1568678400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1568678400000",
    "number": "1184274607",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19188 SOUTHAMPTON DR",
            "city": "LIVONIA",
            "state": "MI",
            "postal_code": "481524106",
            "telephone_number": "248-444-3250"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1777 AXTELL DR STE 100",
            "city": "TROY",
            "state": "MI",
            "postal_code": "480844400",
            "telephone_number": "248-613-5377"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GASKO",
        "first_name": "LOGAN",
        "middle_name": "JADE",
        "credential": "MA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-09-17",
        "last_updated": "2019-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MI",
            "license": "6301018085",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "Troy",
            "affiliation": "N",
            "address_1": "1777 Axtell Dr Ste 100",
            "city": "Troy",
            "state": "MI",
            "country_code": "US",
            "postal_code": "480844400",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Kenneth Garian
• Kristine Ann Garmany, DDS
• Stephanie Ann Garsteck-Polak, CRNA
• Cora Marie Garth, L.L.P.C.
• David John Garvelink, MA LLP
• Gastrointestinal and Liver Disease Specialists PC
• Gastrointestinal Specialists PC
• Desaray Tamira Gatewood
• Jessica Lane Gatt, M.D.
• Sami Gauthier, NP

• Clinical Psychologist in Troy, MI
• Providers in Troy, MI by specialty
• Clinical Psychologist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 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.