Basic Information
| Provider Information | |||||||||
| NPI: | 1952677304 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | GILMAN-YAP | ||||||||
| FirstName: | NICOLE | ||||||||
| MiddleName: | BROOKE | ||||||||
| NamePrefix: | MRS. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MA,BA,LPC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 54 E RAMSDELL ST | ||||||||
| Address2: | |||||||||
| City: | NEW HAVEN | ||||||||
| State: | CT | ||||||||
| PostalCode: | 065151140 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2037814600 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 54 E RAMSDELL ST | ||||||||
| Address2: | |||||||||
| City: | NEW HAVEN | ||||||||
| State: | CT | ||||||||
| PostalCode: | 065151140 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2037814600 | ||||||||
| FaxNumber: | 2037814624 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/30/2012 | ||||||||
| LastUpdateDate: | 07/21/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YP2500X | 2967 | CT | Y | Behavioral Health & Social Service Providers | Counselor | Professional |
ID Information
| ID | Type | State | Issuer | Description | 008024427 | 05 | CT | MEDICAID | NOT ELIGIBLE | 01 | CT | CIGNA BEHAVIORAL HEALTH | OTHER | 060669107 | 01 | CT | UBH/UNITED HEALTHCARE WELLMORE GRP/FACILITY | OTHER | 008039745 | 05 | CT | MEDICAID | 008023170 | 05 | CT | MEDICAID | 060669107 | 01 | CT | ANTHEM BCBS OF CT WELLMORE GRP/FACILITY | OTHER | NOT ELIGIBLE | 01 | CT | MHN MANAGED HEALTHNETWORK | OTHER | 008065488 | 05 | CT | MEDICAID | 060669107 | 01 | CT | UBH/CONNECTICARE WELLMORE GRP/FACILITY | OTHER | 13830404 | 01 | CT | CAQH | OTHER | D339123 | 01 | CT | BEACON HEALTH STRATEGIES | OTHER | 0606691007 | 01 | CT | OPTUM BEHAVIORAL HEALTH/UBH WELLMORE GRP/FACILITY | OTHER | NOT ELIGIBLE | 01 | CT | MHN/TRICARENORTH | OTHER | PENDING | 01 | CT | AETNA BEHAVIORAL HEALTH | OTHER | 060669107 | 01 | CT | UBH/OXFORD LIBERTY/FREEDOM WELLMORE GRP/FACILITY | OTHER |