Latasha Gardner, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

2820 Issued in CT

Practice address

816 Broad St
Suite 23
Meriden, CT 06450-4350

Phone

(203) 630-2499

Fax

(203) 630-2499

NPI assigned

Apr 29, 2016

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

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1461888000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1461888000000",
    "number": "1235584095",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "70 CRANBERRY LN",
            "city": "CHESHIRE",
            "state": "CT",
            "postal_code": "064103503",
            "telephone_number": "203-630-2488",
            "fax_number": "203-630-2499"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "816 BROAD ST",
            "address_2": "SUITE 23",
            "city": "MERIDEN",
            "state": "CT",
            "postal_code": "064504350",
            "telephone_number": "203-630-2499",
            "fax_number": "203-630-2499"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GARDNER",
        "first_name": "LATASHA",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-04-29",
        "last_updated": "2016-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "CT",
            "license": "2820",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "008062953",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Gerard Fumo, DO
• Ingrid Teixeira Furchi
• James Joseph Gallagher III, M.D.
• Eduard Galper
• Sarah Gantley, APRN
• Christopher Gash, LCSW
• Jessica Gaudioso, LCSW
• Michelle Sara Gauthier, APRN
• Amber Lynn Gazerwitz, LMFT
• Genoa Healthcare LLC

• Professional Counselor in Meriden, CT
• Providers in Meriden, CT by specialty
• Professional Counselor in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2016; 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.