Individual provider Active NPI

Bailey Gasper, LMHCA

  • Mental Health Counselor
  • Fort Wayne, IN
National Provider Identifier
1790537983
Registry record updated Apr 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
88002031A Issued in IN
Practice address
10343 Dawsons Creek Blvd Ste a
Fort Wayne, IN 46825-1906
Phone
(260) 267-0498
NPI assigned
Apr 2, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 2, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 88002031A IN Primary

Addresses

Primary practice location

10343 Dawsons Creek Blvd Ste a
Fort Wayne, IN 46825-1906

Mailing address

3909 Castell Dr
Fort Wayne, IN 46835-2173
Phone (260) 410-1747

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
88002031AINMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1712016000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712016000000",
    "number": "1790537983",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3909 CASTELL DR",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468352173",
            "telephone_number": "260-410-1747"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10343 DAWSONS CREEK BLVD STE A",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468251906",
            "telephone_number": "260-267-0498"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GASPER",
        "first_name": "BAILEY",
        "credential": "LMHCA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-04-02",
        "last_updated": "2024-04-02",
        "certification_date": "2024-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "IN",
            "license": "88002031A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Wayne, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 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.