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Deactivated NPI 1669744991 Deactivated / Inactive NPI Female Practitioner

Lisbeth Gannon , LPC

Counselor - Professional • Madison, CT

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Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Lisbeth Gannon has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date February 02, 2012
NPI Deactivation Date July 29, 2020
Total Practice Duration ~8 Years of Practice (2012 – 2020)

Professional Overview & Biography Verified Profile Summary

Lisbeth Gannon, LPC was a registered Counselor - Professional practicing in Madison, CT. Throughout an active medical career spanning 8 years, Lisbeth Gannon provided care at the practice location at 147 DURHAM RD STE 13 until profile deactivation on 2020-07-29.

Practice Location & Contact Primary Location

Practice Address

147 Durham Rd Ste 13

Madison, CT 064432678

Telephone 8605758700
Associated Practice Facility / Clinic
🏢 Clear The Way Counseling Llc Facility NPI 1740899491

Specialty Benchmarks & Practice Insights

Comparative analytics for Counselor - Professional in Madison, CT

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 7.0 Yrs
State Avg: 16.1 Yrs
Regional Practice Density
25 Specialists

Practicing in Madison, CT (2870 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

CMS Verified: 2025-06-26
Counselor - Professional Primary Specialty

NUCC Taxonomy Code: 101YP2500X

State License CT 002159

Definition to come...

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

14 Historical Events
📍
Updated Practice Location June 26, 2025

Registered at 147 DURHAM RD STE 13, MADISON, CT 064432678 (Tel: 8605758700)

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Updated Business Mailing Address June 26, 2025

Registered at 446 EVERGREEN AVE, HAMDEN, CT 065182406 (Tel: 8605758700)

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Provider Name / Credentials Updated August 24, 2021

Recorded as LISBETH GANNON, LPC

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Updated Practice Location August 27, 2020

Registered at 229 BACON POND RD APT 154, WOODBURY, CT 067983692 (Tel: 8605758700)

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Updated Business Mailing Address August 27, 2020

Registered at 229 BACON POND RD APT 154, WOODBURY, CT 067983692 (Tel: 8605758700)

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Provider Name / Credentials Updated August 27, 2020

Recorded as LISBETH GANNON, M.A.

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Medical Taxonomy / Specialty Registered (Primary Specialty) August 27, 2020

Counselor (License #002159 in CT)

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NPI Profile Deactivated July 29, 2020

Record deactivated on July 29, 2020

NPI Profile Active March 05, 2012

NPI status registered as active in NPPES database

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Updated Practice Location March 05, 2012

Registered at 331 WETHERSFIELD AVE, HARTFORD, CT 061141420 (Tel: 8602364511)

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Updated Business Mailing Address March 05, 2012

Registered at 331 WETHERSFIELD AVE, HARTFORD, CT 061141420 (Tel: 8602364511)

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Provider Name / Credentials Updated March 05, 2012

Recorded as LISBETH GANNON, M.A.

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Medical Taxonomy / Specialty Registered (Primary Specialty) March 05, 2012

Counselor (License #002159 in CT)

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Initial NPI Registration & Enumeration February 02, 2012

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1669744991
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: February 02, 2012
Last Update: June 26, 2025
Deactivation Date: July 29, 2020
Sole Proprietor: Yes

Mailing Address

446 Evergreen Ave

Hamden, CT 065182406

Phone: 8605758700

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

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