Active NPI
W Michael Gaynor, LADC1
- Counselor
- Springfield, MA
National Provider Identifier
1891837142
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counselor
- Practice address
- 2155 Main Street
Springfield, MA 01104 - Phone
- (413) 736-0395
- Fax
- (413) 734-1651
- NPI assigned
- Feb 13, 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 |
|---|---|---|---|---|
| Counselor | 101Y00000X | Primary |
Addresses
Primary practice location
2155 Main Street
Springfield, MA 01104
Mailing address
147 Norman Street
West Springfield, MA 01105
Phone (413) 788-0929
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1171324800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1891837142",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "147 NORMAN STREET",
"city": "WEST SPRINGFIELD",
"state": "MA",
"postal_code": "01105",
"telephone_number": "413-788-0929",
"fax_number": "413-732-5362"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2155 MAIN STREET",
"city": "SPRINGFIELD",
"state": "MA",
"postal_code": "01104",
"telephone_number": "413-736-0395",
"fax_number": "413-734-1651"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GAYNOR",
"first_name": "W",
"middle_name": "MICHAEL",
"name_prefix": "Mr.",
"credential": "LADC1",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-02-13",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Springfield, MA
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.