Laurie L Gambardella, LPC
Individual provider Active NPI Professional Counselor · Prospect, CT
NPI 1902199409 · NPPES record last updated Jun 27, 2023
Key facts
- NPI
- 1902199409
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Professional Counselor 101YP2500X
- License
- 003724 (VA)
- Practice address
- 11 Tamarack CT
Prospect, CT 06712-6413 - Phone
- (336) 508-1298
- NPI assigned
- May 17, 2011
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 003724 | VA | MD | Professional Counselor |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 003724 | VA | Yes |
| Case Manager/Care Coordinator | 171M00000X |
Addresses
Primary practice location
11 Tamarack CT
Prospect, CT 06712-6413
Mailing address
11 Tamarack CT
Prospect, CT 06712-6413
Phone (336) 508-1298
Other providers in Prospect, CT
- Alexandra Elizabeth Ford
- Nicholas A Forte Jr.
- Full Spectrum Therapeutics LLC
- Leonard J Fusco
- Laura Galindo
- Catherine Gelinas
- Stephanie Genest
- Karl Benjamin Genovese
- Christy Ann George
- Kathleen Golebiewski
All providers in Prospect, CT · Professional Counselor in Connecticut
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 27, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.