Erik Michael Gagnon

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

LISAC-10189 Issued in AZ

Practice address

3821 N 15TH Ave
Phoenix, AZ 85015-5545

Phone

(602) 535-9296

NPI assigned

Jun 23, 2020

Sex

Male

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Hope for Healing Counseling LLC

  • Mental Health Counselor
  • Bennington, VT
  • NPI 1063932424
  NPD (past)

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

{
    "created_epoch": "1592870400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635811200000",
    "number": "1861018079",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3821 N 15TH AVE",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850155545",
            "telephone_number": "602-535-9296"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3821 N 15TH AVE",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850155545",
            "telephone_number": "602-535-9296"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAGNON",
        "first_name": "ERIK",
        "middle_name": "MICHAEL",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-06-23",
        "last_updated": "2021-11-02",
        "certification_date": "2021-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "AZ",
            "license": "LISAC-10189",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ronald Anthony Gagliano Jr., M.D.
• Dominique Gagne, MD
• Mary Sharyle Gagnepain, SLP
• Charles E Gagnon, D.O.
• Cindy Bartlett Gagnon
• Grace Gagnon
• Marie Lemay Gagnon, RN
• Adriana Gaidici, M.D.
• Florin Gaidici, M.D.
• Aaron Gaie

• Mental Health Counselor in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Mental Health Counselor in Arizona

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