Provider Demographics
NPI:1861711566
Name:GAYNOR, CLAUDETTE A (LMHC)
Entity type:Individual
Prefix:MS
First Name:CLAUDETTE
Middle Name:A
Last Name:GAYNOR
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4439 REGAL CT
Mailing Address - Street 2:
Mailing Address - City:DELRAY BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33445-3829
Mailing Address - Country:US
Mailing Address - Phone:561-542-6305
Mailing Address - Fax:
Practice Address - Street 1:4439 REGAL CT
Practice Address - Street 2:
Practice Address - City:DELRAY BEACH
Practice Address - State:FL
Practice Address - Zip Code:33445-3829
Practice Address - Country:US
Practice Address - Phone:561-880-6220
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-20
Last Update Date:2017-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH10194101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health