Marline Louisedith Gousse

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

Practice address

42 S Center St
Frackville, PA 17931-1647

Phone

(570) 593-5484

NPI assigned

Nov 8, 2024

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 5

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

Locations

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.

• Gym-Jam Therapeutics, Inc.

  • Community/Behavioral Health Agency
  • Pottsville, PA
  • NPI 1801337910

  Behavior Analyst

  NPD
• Pivotal Interventions, Inc

  • Multi-Specialty Clinic/Center
  • Pottsville, PA
  • NPI 1366966996

  Behavior Analyst

  NPD

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

{
    "created_epoch": "1731024000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731024000000",
    "number": "1265256010",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "150 CHAMBERLAINE AVE",
            "city": "POTTSVILLE",
            "state": "PA",
            "postal_code": "179018648",
            "telephone_number": "570-593-5484"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "42 S CENTER ST",
            "city": "FRACKVILLE",
            "state": "PA",
            "postal_code": "179311647",
            "telephone_number": "570-593-5484"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOUSSE",
        "first_name": "MARLINE",
        "middle_name": "LOUISEDITH",
        "name_prefix": "Miss",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-11-08",
        "last_updated": "2024-11-08",
        "certification_date": "2024-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Frackville Pharmacy Inc
• Shirley Ann French, CRNP, RPH
• Geisinger Clinic
• Good Samaritan Regional Medical Center
• Tanya A Goodman, MS, CAADC, LPC
• Thomas R. Graf, M.D.
• James C Greenfield, DO
• Timothy Guy Grube, D.O.
• Raymond Edward Hische, DMD
• Lauren Hoffman, MS, CCC-SLP

• All providers in Frackville, PA
• Behavior Analyst in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.