Gidget Q.V. Rafus-Rousell, CASAC II

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

005006-1 Issued in NY

Practice address

80 State Highway 310 Ste 1
St. Lawrence County Community
Canton, NY 13617-1436

Phone

(315) 386-2167

NPI assigned

Sep 29, 2011

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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

Specialty

Mental Health Counselor

Education

Other, 2005

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Professional Medical Concierge Services PLLCGroup PAC ID 0840614020, 75 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Professional Medical Concierge Services, PLLC

  • Family Medicine Physician
  • Saratoga Springs, NY
  • NPI 1841812310

  Mental Health

  Medicare reassignment Care Compare group NPD
• St Lawrence County

  • Community/Behavioral Health Agency
  • Canton, NY
  • NPI 1699898635

  Addiction (Substance Use Disorder)

  NPD (past)

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

{
    "created_epoch": "1317254400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1520380800000",
    "number": "1376827196",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "80 STATE HIGHWAY 310 STE 1",
            "city": "CANTON",
            "state": "NY",
            "postal_code": "136171436",
            "telephone_number": "315-386-2167"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "80 STATE HIGHWAY 310 STE 1",
            "address_2": "ST. LAWRENCE COUNTY COMMUNITY",
            "city": "CANTON",
            "state": "NY",
            "postal_code": "136171436",
            "telephone_number": "315-386-2167"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAFUS-ROUSELL",
        "first_name": "GIDGET",
        "middle_name": "Q.V.",
        "name_prefix": "Ms.",
        "credential": "CASAC II",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-09-29",
        "last_updated": "2018-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NY",
            "license": "22453",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NY",
            "license": "005006-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Relani Prudhomme, LCSW
• Brooke C Pryce
• R R S Inc
• R.B. Lawrence Inc.
• Terry M. Rafferty, LMSW
• Thivisa Rajagopal, M.D.
• Crystal Ralston, LMHC, ADVANCED CASAC
• Linda T. Reece, OTR/L
• Jamie L Reed
• Sabrina Reed

• Mental Health Counselor in Canton, NY
• Providers in Canton, NY by specialty
• Mental Health Counselor in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.