Individual provider Active NPI

Luke J. Gilleran, MA, NCC, LACD, CCDP

  • Addiction (Substance Use Disorder) Counselor
  • New Haven, CT
National Provider Identifier
1194961961
Registry record updated Jan 7, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
000857 Issued in CT
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

Updated by the provider on Jan 7, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
004041000MedicaidCT
008003745MedicaidCT
008038039MedicaidCT

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

LicenseStateTypeSpecialty
000857CTMDProfessional 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.

Verify at the official NPI Registry.