Provider Demographics
NPI:1740050434
Name:DANIEL N GASPER LCPC LADC LLC
Entity type:Organization
Organization Name:DANIEL N GASPER LCPC LADC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PROVIDER
Authorized Official - Prefix:
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:N
Authorized Official - Last Name:GASPER
Authorized Official - Suffix:
Authorized Official - Credentials:LCPC LADC
Authorized Official - Phone:207-530-7774
Mailing Address - Street 1:7 SHOP HILL RD
Mailing Address - Street 2:
Mailing Address - City:MILBRIDGE
Mailing Address - State:ME
Mailing Address - Zip Code:04658-3029
Mailing Address - Country:US
Mailing Address - Phone:207-530-7774
Mailing Address - Fax:
Practice Address - Street 1:87 MILBRIDGE RD
Practice Address - Street 2:
Practice Address - City:CHERRYFIELD
Practice Address - State:ME
Practice Address - Zip Code:04622-4403
Practice Address - Country:US
Practice Address - Phone:207-530-7774
Practice Address - Fax:207-546-2100
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-04
Last Update Date:2024-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty
No251S00000XAgenciesCommunity/Behavioral HealthGroup - Single Specialty