Individual provider Active NPI

Alicia Sara Jones Gorman, LMHC

  • Mental Health Counselor
  • Plattsburgh, NY
National Provider Identifier
1174911614
Registry record updated Jan 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
007560-1 Issued in NY
Practice address
8 Broad St
Plattsburgh, NY 12901-3420
Phone
(518) 825-1555
Fax
(518) 825-1550
NPI assigned
Jan 7, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 22, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 007560-1 NY Primary

Addresses

Primary practice location

8 Broad St
Plattsburgh, NY 12901-3420

Mailing address

8 Broad St
Plattsburgh, NY 12901-3420
Phone (518) 825-1555

Other names 1

  • Alicia Jones Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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

Enrollment IDStateProvider typePAC IDDetails
I20240129001607 NY Practitioner - Mental Health Counselor 6507237245 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
North Country Behavioral Medicine PLLCGroup PAC ID 2668744756, 22 clinicians

Practice addresses (Care Compare)

8 Broad St
Plattsburgh, NY 12901-3420
Phone (518) 825-1555

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
007560-1NYMDRegistered Dietitian
007560NYMDAcupuncturist

Practice roles

OrganizationSpecialtyStatusNew patients
North Country Behavioral Medicine PLLC CurrentSince Jan 1, 2024 Accepting new patients
Citizen Advocates, Inc PastSince Aug 14, 2022 Accepting new patients
Citizen Advocates, Inc PastSince Nov 1, 2010 Accepting new patients

Locations

8 Broad St
Plattsburgh, NY 12901
Phone (518) 563-8880

Organizations & group practices 3

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

NPI Registry JSON

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

{
    "created_epoch": "1420588800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705881600000",
    "number": "1174911614",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8 BROAD ST",
            "city": "PLATTSBURGH",
            "state": "NY",
            "postal_code": "129013420",
            "telephone_number": "518-825-1555",
            "fax_number": "518-825-1550"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8 BROAD ST",
            "city": "PLATTSBURGH",
            "state": "NY",
            "postal_code": "129013420",
            "telephone_number": "518-825-1555",
            "fax_number": "518-825-1550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GORMAN",
        "first_name": "ALICIA",
        "middle_name": "SARA JONES",
        "credential": "LMHC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-01-07",
        "last_updated": "2024-01-22",
        "certification_date": "2024-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NY",
            "license": "007560-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ALICIA",
            "last_name": "JONES",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Plattsburgh, NY

Sources for this page

Verify at the official NPI Registry.