Beth Gaillard, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

12777 Issued in CT

Practice address

60 Connolly Pkwy BLDG 17a
Hamden, CT 06514-2519

Phone

(203) 230-2815

NPI assigned

Feb 7, 2023

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

Medicare fee-for-service enrollment

Enrolled in CT

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

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Grow Healthcare Group PA

  • Mental Health Counselor
  • Miami, FL
  • NPI 1245845932

  Clinical, CT

  Medicare reassignment NPD
• Reachout, Inc.

  • Early Intervention Provider Agency
  • Hamden, CT
  • NPI 1851739098
  NPD (past)

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

{
    "created_epoch": "1675728000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675728000000",
    "number": "1457057770",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "165 MEADOW PARK DR",
            "city": "MILFORD",
            "state": "CT",
            "postal_code": "064612623",
            "telephone_number": "860-655-2222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "60 CONNOLLY PKWY BLDG 17A",
            "city": "HAMDEN",
            "state": "CT",
            "postal_code": "065142519",
            "telephone_number": "203-230-2815"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAILLARD",
        "first_name": "BETH",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-02-07",
        "last_updated": "2023-02-07",
        "certification_date": "2023-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CT",
            "license": "12777",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Daniel Lee Fudge, PH.D.
• Carlee Fuller
• Casey J Fusco
• Thomas Fynan, MD
• G.P. of Hamden, PC.
• Karen Galvin, PT/MPT
• Raymond J. Gambardella, DMD
• Taires Gamble
• Gambrell Behavioral Health Services, LLC
• George Davis Gammon, MD

• Clinical Social Worker in Hamden, CT
• Providers in Hamden, CT by specialty
• Clinical Social Worker in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.