Individual provider Active NPI

Jodyan K Gaynor, MA

  • Professional Counselor
  • West Hartford, CT
National Provider Identifier
1508132630
Registry record updated Aug 30, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
LPC015144 Issued in GA
Practice address
998 Farmington Ave Ste 104
West Hartford, CT 06107-2184
Phone
(860) 592-1030
Fax
(888) 772-1877
NPI assigned
Mar 22, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 30, 2025

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 068.0135631 VT
Mental Health Counselor 101YM0800X
Professional Counselor 101YP2500X 003029 CT
Professional Counselor 101YP2500X LPC015144 GA Primary

Addresses

Primary practice location

998 Farmington Ave Ste 104
West Hartford, CT 06107-2184

Mailing address

998 Farmington Ave Ste 104
West Hartford, CT 06107-2184
Phone (860) 592-1030

Other practice location 1

39 Orchard St
East Hartford, CT 06108-2123
Phone (203) 936-8818

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20240220000355 CT Practitioner - Mental Health Counselor 8325482227 Reassigns benefits to 1 organization
Practice locations: West Hartford, CT

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
068.0135631VTMDMental Health Counselor
LPC015144GAMDProfessional Counselor
003029CTMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Integrity Counseling and Consultation LLC Professional Current Accepting new patients
Mental Health Specialty Group PA Mental Health CurrentSince Jan 6, 2025 Accepting new patients
Teladoc Health Medical Group, P.a. Mental Health Current Accepting new patients

Locations

145 Pine Haven Shores Rd
Ste 100077
Shelburne, VT 05482

Interoperability endpoints

  • Direct secure messaging: jodyangaynor@tdh.allscriptsdirect.net

Organizations & group practices 3

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": "1332374400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1756512000000",
    "number": "1508132630",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "998 FARMINGTON AVE STE 104",
            "city": "WEST HARTFORD",
            "state": "CT",
            "postal_code": "061072184",
            "telephone_number": "860-592-1030",
            "fax_number": "888-772-1877"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "998 FARMINGTON AVE STE 104",
            "city": "WEST HARTFORD",
            "state": "CT",
            "postal_code": "061072184",
            "telephone_number": "860-592-1030",
            "fax_number": "888-772-1877"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "39 Orchard St",
            "address_purpose": "LOCATION",
            "city": "East Hartford",
            "state": "CT",
            "postal_code": "061082123",
            "country_code": "US",
            "telephone_number": "203-936-8818",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GAYNOR",
        "first_name": "JODYAN",
        "middle_name": "K",
        "credential": "MA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-03-22",
        "last_updated": "2025-08-30",
        "certification_date": "2025-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "VT",
            "license": "068.0135631",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "CT",
            "license": "003029",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "GA",
            "license": "LPC015144",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Hartford, CT

Sources for this page

Verify at the official NPI Registry.