Healthcare Provider Details

I. General information

NPI: 1265341770
Provider Name (Legal Business Name): CELIA J GAGNON LCAT, LPAT, ATR-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/02/2026
Last Update Date: 09/02/2026
Certification Date: 09/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

170 W END AVE APT 10E
NEW YORK NY
10023-5409
US

IV. Provider business mailing address

170 W END AVE APT 10E
NEW YORK NY
10023-5409
US

V. Phone/Fax

Practice location:
  • Phone: 650-787-8095
  • Fax:
Mailing address:
  • Phone: 650-787-8095
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code221700000X
TaxonomyArt Therapist
License Number002527-01
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: