Kerry Renjilian Gough, LPCC, LMHC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Practice address

111 South St
Somerville, MA 02143-4297

Phone

(617) 284-5130

NPI assigned

Feb 11, 2013

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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.

• Riverside Community Care, Inc.

  • Community/Behavioral Health Agency
  • Norwood, MA
  • NPI 1780791467
  NPD (past)

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

{
    "created_epoch": "1360540800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1547424000000",
    "number": "1447599444",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "674 COUNTY SQUARE DR STE 106E",
            "city": "VENTURA",
            "state": "CA",
            "postal_code": "930030439",
            "telephone_number": "805-881-3001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 SOUTH ST",
            "city": "SOMERVILLE",
            "state": "MA",
            "postal_code": "021434297",
            "telephone_number": "617-284-5130"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOUGH",
        "first_name": "KERRY",
        "middle_name": "RENJILIAN",
        "credential": "LPCC, LMHC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-02-11",
        "last_updated": "2019-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Colin Michael Goodbred, RN
• Edward F Goodman, M.D.
• Dana Jill Gordon
• Lorraine Betwenik Gotlib, RNCS
• Aliya M Gottehrer Cohen
• Anna Victoria Gould
• Robert Graceffo, PHD
• Maria Grant
• Caroline Guyer Gray, LICSW
• Caroline Shannon Graziano, MSW, LCSW

• Mental Health Counselor in Somerville, MA
• Providers in Somerville, MA by specialty
• Mental Health Counselor in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2019; 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.