Individual provider Active NPI

Clare Gagne, CLC

  • Lactation Consultant (Non-RN)
  • Ridgewood, NY
National Provider Identifier
1629656962
Registry record updated Mar 30, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Lactation Consultant (Non-RN)Taxonomy code 174N00000X
License
ALLP-310860 Issued in MA
Practice address
376 Woodward Ave Apt 2R
Ridgewood, NY 11385-1357
Phone
(414) 943-3488
NPI assigned
Mar 30, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 30, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Lactation Consultant (Non-RN) 174N00000X ALLP-310860 MA Primary

Addresses

Primary practice location

376 Woodward Ave Apt 2R
Ridgewood, NY 11385-1357

Mailing address

376 Woodward Ave Apt 2R
Ridgewood, NY 11385-1357
Phone (414) 943-3488

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
ALLP-310860MAMDLactation Consultant (Non-RN)

NPI Registry JSON

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

{
    "created_epoch": "1617062400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617062400000",
    "number": "1629656962",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "376 WOODWARD AVE APT 2R",
            "city": "RIDGEWOOD",
            "state": "NY",
            "postal_code": "113851357",
            "telephone_number": "414-943-3488"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "376 WOODWARD AVE APT 2R",
            "city": "RIDGEWOOD",
            "state": "NY",
            "postal_code": "113851357",
            "telephone_number": "414-943-3488"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAGNE",
        "first_name": "CLARE",
        "credential": "CLC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-03-30",
        "last_updated": "2021-03-30",
        "certification_date": "2021-03-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174N00000X",
            "taxonomy_group": "",
            "desc": "Lactation Consultant, Non-RN",
            "state": "MA",
            "license": "ALLP-310860",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ridgewood, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2021; 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.