Active NPI
Clevetta Laverne Gilliam
- Professional Counselor
- Middletown, CT
National Provider Identifier
1992522809
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- Practice address
- 20 Tuttle PL
Middletown, CT 06457-1870 - Phone
- (860) 793-4448
- Fax
- (860) 793-3369
- NPI assigned
- Sep 23, 2024
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | Primary |
Addresses
Primary practice location
20 Tuttle PL
Middletown, CT 06457-1870
Mailing address
PO Box 102
West Haven, CT 06516-0102
Phone (203) 214-4524
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": "1727049600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1727136000000",
"number": "1992522809",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 102",
"city": "WEST HAVEN",
"state": "CT",
"postal_code": "065160102",
"telephone_number": "203-214-4524"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "20 TUTTLE PL",
"city": "MIDDLETOWN",
"state": "CT",
"postal_code": "064571870",
"telephone_number": "860-793-4448",
"fax_number": "860-793-3369"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GILLIAM",
"first_name": "CLEVETTA",
"middle_name": "LAVERNE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-09-23",
"last_updated": "2024-09-24",
"certification_date": "2024-09-24",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Middletown, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.