Organization Active NPI

Michelle Gasper Professional Clinical Counselor Canvas Counseling Cent

Doing business as Canvas Counseling Center

  • Marriage & Family Therapist
  • Chino, CA
National Provider Identifier
1891485868
Registry record updated Jan 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
Legal business name
MICHELLE GASPER PROFESSIONAL CLINICAL COUNSELOR CANVAS COUNSELING CENT
Doing business as
Canvas Counseling Center
Practice address
4091 Riverside Dr Ste 103
Chino, CA 91710-3195
Phone
(909) 654-8079
Fax
(909) 774-0142
NPI assigned
May 11, 2023
Last updated
Jan 23, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 23, 2025

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

Authorized official

Name
Michelle J Gasper, LMFT LPCCNPI 1265080964
Title
Ceo, Therapist
Phone
(909) 240-0419

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X NU
Marriage & Family Therapist 106H00000X NU Primary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X NU

Addresses

Primary practice location

4091 Riverside Dr Ste 103
Chino, CA 91710-3195

Mailing address

4091 Riverside Dr Ste 103
Chino, CA 91710-3195
Phone (909) 654-8079

Other names 1

  • Canvas Counseling Center Doing business as

National Provider Directory

National Provider Directory

Locations

4091 Riverside Dr
Ste 103
Chino, CA 91710
Phone (909) 654-8079

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1683763200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1737590400000",
    "number": "1891485868",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4091 RIVERSIDE DR STE 103",
            "city": "CHINO",
            "state": "CA",
            "postal_code": "917103195",
            "telephone_number": "909-654-8079"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4091 RIVERSIDE DR STE 103",
            "city": "CHINO",
            "state": "CA",
            "postal_code": "917103195",
            "telephone_number": "909-654-8079",
            "fax_number": "909-774-0142"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MICHELLE GASPER PROFESSIONAL CLINICAL COUNSELOR CANVAS COUNSELING CENT",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-05-11",
        "last_updated": "2025-01-23",
        "certification_date": "2025-01-23",
        "status": "A",
        "authorized_official_last_name": "GASPER",
        "authorized_official_first_name": "MICHELLE",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "CEO, THERAPIST",
        "authorized_official_telephone_number": "909-240-0419",
        "authorized_official_credential": "LMFT LPCC"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Canvas Counseling Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Chino, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2025; 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.