Marissa R Gagliardo, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

3151 Issued in CT

Practice address

232 Cedar Street
South Central Rehabilitation Center
New Haven, CT 06519-1610

Phone

(203) 503-3300

Fax

(203) 401-3352

NPI assigned

Jul 9, 2014

Last updated

Feb 1, 2018By the provider in NPPES

Sex

Female

Sole proprietor

No

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

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Cornell Scott Hill Health Corporation

  • Federally Qualified Health Center (FQHC)
  • New Haven, CT
  • NPI 1902921380
  Medicare reassignment NPD
• Clear Path Therapy LLC

  • Professional Counselor
  • Monroe, CT
  • NPI 1821647199
  NPD Authorized official

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

{
    "created_epoch": "1404864000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1517443200000",
    "number": "1871909945",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7720",
            "address_2": "CREDENTIALING SPECIALIST",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065190720",
            "telephone_number": "203-503-3174",
            "fax_number": "203-503-3183"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "232 CEDAR STREET",
            "address_2": "SOUTH CENTRAL REHABILITATION CENTER",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065191610",
            "telephone_number": "203-503-3300",
            "fax_number": "203-401-3352"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAGLIARDO",
        "first_name": "MARISSA",
        "middle_name": "R",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-07-09",
        "last_updated": "2018-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "CT",
            "license": "3151",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Allison Elizabeth Gaffey, PH.D.
• Jenna Gage
• Jonathan E Gage, M.D.
• Fred Vincent Gager I, M.D.
• Lia Marie Gagliardi
• Jean-Pierre Gagne, M.D., PH.D.
• Meghan Marie Gagnon, PHARMD
• Johneshia Gagum-Wilson, LPN
• Helmuth W Gahbauer, MD
• Jill Katherine Jinks Gaidos, MD

• Professional Counselor in New Haven, CT
• Providers in New Haven, CT by specialty
• Professional Counselor in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.