Individual provider Active NPI

Jessica Ann Fortier-Goss, LADCI

  • Addiction (Substance Use Disorder) Counselor
  • Fitchburg, MA
National Provider Identifier
1477936912
Registry record updated Jul 1, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
2327 Issued in MA
Practice address
155 Airport Rd
Fitchburg, MA 01420-8142
Phone
(978) 343-6300
NPI assigned
Jul 1, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 1, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 2327 MA Primary

Addresses

Primary practice location

155 Airport Rd
Fitchburg, MA 01420-8142

Mailing address

531 Lindell Ave
Leominster, MA 01453-5451

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
2327MAMDPrimary Podiatric Medicine Podiatrist

NPI Registry JSON

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

{
    "created_epoch": "1435708800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1435708800000",
    "number": "1477936912",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "531 LINDELL AVE",
            "city": "LEOMINSTER",
            "state": "MA",
            "postal_code": "014535451"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "155 AIRPORT RD",
            "city": "FITCHBURG",
            "state": "MA",
            "postal_code": "014208142",
            "telephone_number": "978-343-6300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FORTIER-GOSS",
        "first_name": "JESSICA",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "credential": "LADCI",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-07-01",
        "last_updated": "2015-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "MA",
            "license": "2327",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fitchburg, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2015; 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.