Active NPI
Nathaniel Gautier, LGPC
- Professional Counselor
- Ellicott City, MD
National Provider Identifier
1215604244
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- LGP15694
- Practice address
- 5054 Dorsey Hall Dr
Ellicott City, MD 21042-7744 - Phone
- (410) 838-9500
- NPI assigned
- Aug 26, 2021
- 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 |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | LGP15694 | MD | Primary |
Addresses
Primary practice location
5054 Dorsey Hall Dr
Ellicott City, MD 21042-7744
Mailing address
5054 Dorsey Hall Dr
Ellicott City, MD 21042-7744
Phone (410) 838-9500
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
| License | State | Type | Specialty |
|---|---|---|---|
| LGP15694 | MD | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1629936000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1729468800000",
"number": "1215604244",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5054 DORSEY HALL DR",
"city": "ELLICOTT CITY",
"state": "MD",
"postal_code": "210427744",
"telephone_number": "410-838-9500"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5054 DORSEY HALL DR",
"city": "ELLICOTT CITY",
"state": "MD",
"postal_code": "210427744",
"telephone_number": "410-838-9500"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GAUTIER",
"first_name": "NATHANIEL",
"credential": "LGPC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2021-08-26",
"last_updated": "2024-10-21",
"certification_date": "2024-10-21",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "MD",
"license": "LGP15694",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Ellicott City, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.