Individual provider Active NPI

Ashley Smith Gallant, LCPC

  • Counselor
  • Nottingham, MD
National Provider Identifier
1417548561
Registry record updated Feb 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
License
LGP11150 Issued in MD
Practice address
5022 Campbell Blvd Ste L-M
Nottingham, MD 21236
Phone
(443) 442-1568
NPI assigned
Feb 1, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 11, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X LGP11150 MD Primary

Addresses

Primary practice location

5022 Campbell Blvd Ste L-M
Nottingham, MD 21236

Mailing address

5022 Campbell Blvd Ste L-M
Nottingham, MD 21236-4969
Phone (443) 442-1568

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL als218@gmail.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250227002428 MD Practitioner - Mental Health Counselor 0941720445

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Aspire Wellness Center IncGroup PAC ID 2961685706, 41 clinicians

Practice addresses (Care Compare)

5022 Campbell Blvd
Suite L M
Nottingham, MD 21236-4969
Phone (443) 442-1568

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LGP11150MDMDCounselor

Practice roles

OrganizationSpecialtyStatusNew patients
Aspire Wellness Center, Inc. CurrentSince Feb 18, 2025 Accepting new patients

Locations

5022 Campbell Blvd
Ste Lm
Nottingham, MD 21236
Phone (443) 442-1568

5022 Campbell Blvd
Ste L
Nottingham, MD 21236
Phone (443) 442-1568

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1612137600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739232000000",
    "number": "1417548561",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5022 CAMPBELL BLVD STE L-M",
            "city": "NOTTINGHAM",
            "state": "MD",
            "postal_code": "212364969",
            "telephone_number": "443-442-1568"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5022 CAMPBELL BLVD STE L-M",
            "city": "NOTTINGHAM",
            "state": "MD",
            "postal_code": "21236",
            "telephone_number": "443-442-1568"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GALLANT",
        "first_name": "ASHLEY",
        "middle_name": "SMITH",
        "credential": "LCPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-02-01",
        "last_updated": "2025-02-11",
        "certification_date": "2025-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "MD",
            "license": "LGP11150",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "als218@gmail.com",
            "affiliation": "N",
            "address_1": "702 W Timonium Rd",
            "city": "Lutherville",
            "state": "MD",
            "country_code": "US",
            "postal_code": "210931826",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Nottingham, MD

Sources for this page

Verify at the official NPI Registry.