Nicholas Gaughan, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

2682 Issued in CT

Practice address

70 Main St
Griswold, CT 06351-2226

Phone

(860) 634-0967

NPI assigned

Apr 3, 2012

Last updated

Dec 1, 2020By the provider in NPPES

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in CT

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Mental Health Counselor

Education

Other, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Life's Journey Counseling LLCGroup PAC ID 6507208758, 5 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.qualifacts.org/api/fhir/soundcommunityservices/r4/

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Life's Journey Counseling LLC

  • Counselor
  • Griswold, CT
  • NPI 1285239228

  Addiction (Substance Use Disorder)

  Medicare reassignment Care Compare group NPD Authorized official
• Community Health Resources, Inc.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Windsor, CT
  • NPI 1215979810
  Medicare reassignment NPD
• Sound Community Services, Inc.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • New London, CT
  • NPI 1396700886
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1333411200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606780800000",
    "number": "1093071136",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 296",
            "city": "ROGERS",
            "state": "CT",
            "postal_code": "062630296",
            "telephone_number": "860-634-0967"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "70 MAIN ST",
            "city": "GRISWOLD",
            "state": "CT",
            "postal_code": "063512226",
            "telephone_number": "860-634-0967"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAUGHAN",
        "first_name": "NICHOLAS",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-04-03",
        "last_updated": "2020-12-01",
        "certification_date": "2020-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CT",
            "license": "001066",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "CT",
            "license": "2682",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LPC",
            "identifier": "2682",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LADC",
            "identifier": "1066",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Michelle Dennis, R.PH.
• Mika Derynioski, OTR/L
• Hannah Margaret Dorff, LCSW
• Kirsten Alexandra Drobiak, PA-C
• Koren Edmond
• Genoa Healthcare LLC
• Griswold Chiropractic, LLC
• Erin Haggan, LCSW
• Healing the Culture LLC
• Lisa A Higgins, MS, CCC-SLP

• Professional Counselor in Griswold, CT
• Providers in Griswold, CT by specialty
• Professional Counselor in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.