Individual provider Active NPI

Velery Nicole Fasano-Gilman, MS

  • Professional Counselor
  • Killeen, TX
National Provider Identifier
1902493554
Registry record updated Dec 30, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
81306 Issued in TX
Practice address
123 Yates Rd
Killeen, TX 76549-6757
Phone
(254) 432-4290
NPI assigned
Dec 30, 2020
Last updated
Dec 30, 2020By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 30, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 81306 TX Primary

Addresses

Primary practice location

123 Yates Rd
Killeen, TX 76549-6757

Mailing address

1100 S Kenney Fort Blvd
Round Rock, TX 78665-2024
Phone (254) 383-0053

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL velfasano@outlook.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
81306TXMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Restorative Hope Sanctuary Professional Current Accepting new patients
Grow Healthcare Group PA Professional CurrentSince Nov 1, 2024 Accepting new patients

Locations

66 W Flagler St
Ste 900
Miami, FL 33130
Phone (786) 244-7711

700 Milam St
Ste 1300
Houston, TX 77002
Phone (281) 801-8391

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1609286400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1609286400000",
    "number": "1902493554",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 S KENNEY FORT BLVD",
            "city": "ROUND ROCK",
            "state": "TX",
            "postal_code": "786652024",
            "telephone_number": "254-383-0053"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "123 YATES RD",
            "city": "KILLEEN",
            "state": "TX",
            "postal_code": "765496757",
            "telephone_number": "254-432-4290"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FASANO-GILMAN",
        "first_name": "VELERY",
        "middle_name": "NICOLE",
        "credential": "MS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-12-30",
        "last_updated": "2020-12-30",
        "certification_date": "2020-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "TX",
            "license": "81306",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "velfasano@outlook.com",
            "affiliation": "N",
            "endpointDescription": "email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "123 Yates Rd",
            "city": "Killeen",
            "state": "TX",
            "country_code": "US",
            "postal_code": "765496757",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Killeen, TX

Sources for this page

Verify at the official NPI Registry.