Cheyenne Gogolinski Ross, LCPC-C
Individual provider Active NPI Counselor · Farmingdale, ME
NPI 1598478166 · NPPES record last updated Dec 28, 2022
Key facts
- NPI
- 1598478166
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Counselor 101Y00000X
- License
- XL6958 (ME)
- Practice address
- 955 Northern Ave
Farmingdale, ME 04344-4632 - Phone
- (207) 370-9351
- NPI assigned
- Dec 28, 2022
- 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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| XL6958 | ME | MD | Counselor |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | XL6958 | ME | Yes |
Addresses
Primary practice location
955 Northern Ave
Farmingdale, ME 04344-4632
Mailing address
955 Northern Ave
Farmingdale, ME 04344-4632
Phone (207) 370-9351
Other providers in Farmingdale, ME
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 28, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.