Active NPI
Dannie Gannon, L.P.C.C.
- Professional Counselor
- Lorain, OH
National Provider Identifier
1861532038
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- E-0004214
- Practice address
- 6140 S Broadway
Lorain, OH 44053-3821 - Phone
- (440) 204-4100
- Fax
- (440) 233-4468
- NPI assigned
- Feb 7, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | E-0004214 | OH | Primary |
Addresses
Primary practice location
6140 S Broadway
Lorain, OH 44053-3821
Mailing address
27582 State Route 58
Wellington, OH 44090-9019
Phone (440) 647-4636
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
| License | State | Type | Specialty |
|---|---|---|---|
| E-0004214 | OH | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1170806400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1861532038",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "27582 STATE ROUTE 58",
"city": "WELLINGTON",
"state": "OH",
"postal_code": "440909019",
"telephone_number": "440-647-4636"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6140 S BROADWAY",
"city": "LORAIN",
"state": "OH",
"postal_code": "440533821",
"telephone_number": "440-204-4100",
"fax_number": "440-233-4468"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GANNON",
"first_name": "DANNIE",
"credential": "L.P.C.C.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-02-07",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "OH",
"license": "E-0004214",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lorain, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.