Kayla Nickerson Gauthier, LMFT

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

1832 Issued in CT

Practice address

41 Williams Ave
Mystic, CT 06355

Phone

(860) 961-5702

NPI assigned

Aug 28, 2016

Last updated

Jun 4, 2018By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

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.

• Kayla Nickerson, LMFT LLC

  • Marriage & Family Therapist
  • Lisbon, CT
  • NPI 1275087884
  NPD (past)

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

{
    "created_epoch": "1472342400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1528070400000",
    "number": "1922554120",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "140 ROSS HILL RD",
            "city": "LISBON",
            "state": "CT",
            "postal_code": "063512824",
            "telephone_number": "860-373-8802"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "41 WILLIAMS AVE",
            "city": "MYSTIC",
            "state": "CT",
            "postal_code": "06355",
            "telephone_number": "860-961-5702"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "18 Oneco St Suite 3",
            "address_purpose": "LOCATION",
            "city": "Norwich",
            "state": "CT",
            "postal_code": "06360",
            "country_code": "US",
            "telephone_number": "860-373-8802",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "83 Town St",
            "address_purpose": "LOCATION",
            "city": "Norwich",
            "state": "CT",
            "postal_code": "063602323",
            "country_code": "US",
            "telephone_number": "860-373-8802",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "204 Sturtevant St Ste 1",
            "address_purpose": "LOCATION",
            "city": "Norwich",
            "state": "CT",
            "postal_code": "063602246",
            "country_code": "US",
            "telephone_number": "860-373-8802",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NICKERSON GAUTHIER",
        "first_name": "KAYLA",
        "credential": "LMFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-08-28",
        "last_updated": "2018-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CT",
            "license": "1832",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Marriage & Family Therapist in Mystic, CT
• Providers in Mystic, CT by specialty
• Marriage & Family Therapist in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2018; 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.