Individual provider Active NPI

Courtney Jaclyn Gingras

  • Professional Counselor
  • San Diego, CA
National Provider Identifier
1447830336
Registry record updated Aug 14, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
LPCC17998 Issued in CA
Practice address
545 Laurel St
San Diego, CA 92101-1634
Phone
(619) 233-4399
Fax
(619) 233-0453
NPI assigned
Apr 13, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 14, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X APCC11756 CA
Student in an Organized Health Care Education/Training Program 390200000X
Professional Counselor 101YP2500X LPCC17998 CA Primary

Addresses

Primary practice location

545 Laurel St
San Diego, CA 92101-1634

Mailing address

545 Laurel St
San Diego, CA 92101-1634
Phone (619) 233-4399

Other practice location 1

1196 Third Ave Fl 1
Chula Vista, CA 91911-3103
Phone (619) 427-4661

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
APCC11756CAMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Community Research Foundation Inc PastSince May 12, 2024 Accepting new patients
Community Research Foundation Inc PastSince May 12, 2024 Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1618272000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1786665600000",
    "number": "1447830336",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "545 LAUREL ST",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921011634",
            "telephone_number": "619-233-4399",
            "fax_number": "619-233-0453"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "545 LAUREL ST",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921011634",
            "telephone_number": "619-233-4399",
            "fax_number": "619-233-0453"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1196 Third Ave Fl 1",
            "address_purpose": "LOCATION",
            "city": "Chula Vista",
            "state": "CA",
            "postal_code": "919113103",
            "country_code": "US",
            "telephone_number": "619-427-4661",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GINGRAS",
        "first_name": "COURTNEY",
        "middle_name": "JACLYN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-04-13",
        "last_updated": "2026-08-14",
        "certification_date": "2026-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": "APCC11756",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "CA",
            "license": "LPCC17998",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2026; 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.