Provider Demographics
NPI:1790432631
Name:GASKIN, CHARLINE ANITRA (LPCA)
Entity type:Individual
Prefix:MS
First Name:CHARLINE
Middle Name:ANITRA
Last Name:GASKIN
Suffix:
Gender:
Credentials:LPCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:50 FITCH STREET 2ND FLOOR
Mailing Address - Street 2:
Mailing Address - City:NEW HAVEN
Mailing Address - State:CT
Mailing Address - Zip Code:06515
Mailing Address - Country:US
Mailing Address - Phone:617-894-4491
Mailing Address - Fax:860-731-5536
Practice Address - Street 1:50 FITCH STREET 2ND FLOOR
Practice Address - Street 2:
Practice Address - City:NEW HAVEN
Practice Address - State:CT
Practice Address - Zip Code:06515
Practice Address - Country:US
Practice Address - Phone:617-894-4491
Practice Address - Fax:860-731-5536
Is Sole Proprietor?:No
Enumeration Date:2022-03-09
Last Update Date:2025-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101Y00000X
CT101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor