Active NPI
Luke J. Gilleran, MA, NCC, LACD, CCDP
- Addiction (Substance Use Disorder) Counselor
- New Haven, CT
National Provider Identifier
1194961961
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction (Substance Use Disorder) Counselor
- License
- 000857
- Practice address
- 1 Long Wharf Dr
Suite 321
New Haven, CT 06511-5991 - Phone
- (203) 781-4357
- NPI assigned
- Dec 29, 2008
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 000857 | CT | Primary |
Addresses
Primary practice location
1 Long Wharf Dr
Suite 321
New Haven, CT 06511-5991
Mailing address
245 Unquowa Rd
Apt #126
Fairfield, CT 06824-5057
Phone (203) 520-3465
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 004041000 | Medicaid | CT | |
| 008003745 | Medicaid | CT | |
| 008038039 | Medicaid | CT |
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
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 000857 | CT | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1230508800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1357516800000",
"number": "1194961961",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "245 UNQUOWA RD",
"address_2": "APT #126",
"city": "FAIRFIELD",
"state": "CT",
"postal_code": "068245057",
"telephone_number": "203-520-3465"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1 LONG WHARF DR",
"address_2": "SUITE 321",
"city": "NEW HAVEN",
"state": "CT",
"postal_code": "065115991",
"telephone_number": "203-781-4357"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GILLERAN",
"first_name": "LUKE",
"middle_name": "J.",
"name_prefix": "Mr.",
"credential": "MA, NCC, LACD, CCDP",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2008-12-29",
"last_updated": "2013-01-07",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "CT",
"license": "000857",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "004041000",
"state": "CT"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "008003745",
"state": "CT"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "008038039",
"state": "CT"
}
],
"endpoints": [],
"other_names": []
}
Other providers in New Haven, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.