NPIMap

Organization Active NPI

Life's Journey Counseling LLC

  • Counselor
  • Griswold, CT
National Provider Identifier
1285239228
Registry record updated Dec 4, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
Legal business name
LIFE'S JOURNEY COUNSELING LLC
Practice address
70 Main St
Griswold, CT 06351-2226
Phone
(860) 634-0967
NPI assigned
Nov 30, 2020
Last updated
Dec 4, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 4, 2020

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

Authorized official

Name
Nicholas Gaughan, LPC/LADCNPI 1093071136
Title
Owner
Phone
(860) 634-0967

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X Primary
Addiction (Substance Use Disorder) Counselor 101YA0400X
Mental Health Counselor 101YM0800X

Addresses

Primary practice location

70 Main St
Griswold, CT 06351-2226

Mailing address

PO Box 296
Rogers, CT 06263-0296
Phone (860) 634-0967

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240521000080 CT Part B Supplier - Clinic/Group Practice 6507208758 Receives reassigned benefits from 6 practitioners
Practice locations: Jewett City, CT

National Provider Directory

National Provider Directory

Locations

70 Main St
Jewett City, CT 06351
Phone (860) 376-7040

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1606694400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1607040000000",
    "number": "1285239228",
    "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": {
        "organization_name": "LIFE'S JOURNEY COUNSELING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-11-30",
        "last_updated": "2020-12-04",
        "certification_date": "2020-12-04",
        "status": "A",
        "authorized_official_last_name": "GAUGHAN",
        "authorized_official_first_name": "NICHOLAS",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "860-634-0967",
        "authorized_official_credential": "LPC/LADC"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Griswold, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.