Individual provider Active NPI

John T Gilleese III, LADC

  • Addiction (Substance Use Disorder) Counselor
  • New London, CT
National Provider Identifier
1437975273
Registry record updated Nov 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
000928 Issued in CT
Practice address
Recovery Twelve Solutions
155 Montauk Ave
New London, CT 06320
Phone
(860) 389-4324
NPI assigned
Nov 26, 2024
Last updated
Nov 26, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 26, 2024

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 000928 CT Primary

Addresses

Primary practice location

Recovery Twelve Solutions
155 Montauk Ave
New London, CT 06320

Mailing address

155 Montauk Ave
New London, CT 06320
Phone (860) 389-4327

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

LicenseStateTypeSpecialty
000928CTMDAddiction (Substance Use Disorder) Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Recovery Twelve Solutions, Inc. Addiction (Substance Use Disorder) CurrentSince Dec 1, 2024 Accepting new patients
Southeastern Pulmonary Assoc. PC PastSince Dec 1, 2024 Accepting new patients

Locations

155 Montauk Ave
New London, CT 06320
Phone (860) 444-2223

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1732579200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732579200000",
    "number": "1437975273",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "155 MONTAUK AVE",
            "city": "NEW LONDON",
            "state": "CT",
            "postal_code": "06320",
            "telephone_number": "860-389-4327",
            "fax_number": "860-574-9676"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "RECOVERY TWELVE SOLUTIONS",
            "address_2": "155 MONTAUK AVE",
            "city": "NEW LONDON",
            "state": "CT",
            "postal_code": "06320",
            "telephone_number": "860-389-4324"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GILLEESE",
        "first_name": "JOHN",
        "middle_name": "T",
        "name_prefix": "Mr.",
        "name_suffix": "III",
        "credential": "LADC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-11-26",
        "last_updated": "2024-11-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CT",
            "license": "000928",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New London, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 26, 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.

Verify at the official NPI Registry.