Jeramie Sousa Gorman, PLPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

2012037683 Issued in MO

Practice address

104 Crescent Dr
Lebanon, MO 65536-3301

Phone

(417) 588-5885

NPI assigned

Nov 5, 2012

Last updated

Nov 5, 2012By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1352073600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1352073600000",
    "number": "1265786891",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "413 HARMONY RD",
            "city": "SEYMOUR",
            "state": "MO",
            "postal_code": "657467223",
            "telephone_number": "417-935-2799"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "104 CRESCENT DR",
            "city": "LEBANON",
            "state": "MO",
            "postal_code": "655363301",
            "telephone_number": "417-588-5885"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GORMAN",
        "first_name": "JERAMIE",
        "middle_name": "SOUSA",
        "name_prefix": "Mr.",
        "credential": "PLPC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-11-05",
        "last_updated": "2012-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "MO",
            "license": "2012037683",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MO",
            "license": "2012037683",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MO",
            "license": "2012037683",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Philip V Giblin, MSW, LCSW
• Ronald D. Glas, MD
• Amanda Carol Glendenning, PT
• Christina Goans, PHARMD
• Gregory R Goodwin, DO
• Mary Kathryn Goslin, LPC
• Monika Goyal, MD
• Jason G Grant, CRNA
• William Grant III, O.D.
• Michelle Marie Gray

• Professional Counselor in Lebanon, MO
• Providers in Lebanon, MO by specialty
• Professional Counselor in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2012; 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.