Jennifer Marie Gogol, MS, LPC

Individual provider Active NPI Professional Counselor · Afton, WY

NPI 1598043226 · NPPES record last updated Feb 3, 2016

Key facts

NPI
1598043226
Entity type
Individual (NPI type 1)
Primary specialty
Professional Counselor 101YP2500X
License
1493 (WY)
Practice address
389 Adams Street
Afton, WY 83110-0000
Phone
(307) 885-9223
Fax
(307) 885-5206
NPI assigned
Jul 29, 2011
Sex
Female
Sole proprietor
No

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
1493WYMDProfessional Counselor

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 1493 WY Yes

Addresses

Primary practice location

389 Adams Street
Afton, WY 83110-0000

Mailing address

PO Box 376
Afton, WY 83110-0376
Phone (307) 885-9883

Other providers in Afton, WY

All providers in Afton, WY · Professional Counselor in Wyoming

Sources for this page

Verify at the official NPI Registry.