Active NPI
Terri L. Gorman, L.C.S.W.
- Professional Counselor
- Canon City, CO
National Provider Identifier
1114258670
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 993001
- Practice address
- 1335 Phay Ave
Suite H
Canon City, CO 81212-2334 - Phone
- (719) 784-7522
- Fax
- (719) 784-7522
- NPI assigned
- Jan 23, 2010
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 993001 | CO | Primary |
Addresses
Primary practice location
1335 Phay Ave
Suite H
Canon City, CO 81212-2334
Mailing address
PO Box 681
Penrose, CO 81240-0681
Phone (719) 784-7522
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1264204800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1291161600000",
"number": "1114258670",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 681",
"city": "PENROSE",
"state": "CO",
"postal_code": "812400681",
"telephone_number": "719-784-7522",
"fax_number": "719-784-7522"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1335 PHAY AVE",
"address_2": "SUITE H",
"city": "CANON CITY",
"state": "CO",
"postal_code": "812122334",
"telephone_number": "719-784-7522",
"fax_number": "719-784-7522"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GORMAN",
"first_name": "TERRI",
"middle_name": "L.",
"credential": "L.C.S.W.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2010-01-23",
"last_updated": "2010-12-01",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "CO",
"license": "993001",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Canon City, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.