Provider Demographics
NPI:1457719379
Name:GASTON-TOUSSAINT, GLORIANN
Entity Type:Individual
Prefix:
First Name:GLORIANN
Middle Name:
Last Name:GASTON-TOUSSAINT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 S BUMBY AVE
Mailing Address - Street 2:UNIT B12
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32803-6276
Mailing Address - Country:US
Mailing Address - Phone:386-214-7934
Mailing Address - Fax:
Practice Address - Street 1:101 S BUMBY AVE
Practice Address - Street 2:UNIT B12
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32803-6276
Practice Address - Country:US
Practice Address - Phone:386-214-7934
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-02-06
Last Update Date:2016-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101Y00000X, 101YA0400X, 106H00000X, 282N00000X
FLISW 9895104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No282N00000XHospitalsGeneral Acute Care Hospital