Individual provider Active NPI

Carrie Gosselin, M.A., LCPC

  • Professional Counselor
  • Lewiston, ME
National Provider Identifier
1659559839
Registry record updated Aug 21, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
CC3842 Issued in ME
Practice address
1155 Lisbon St
Lewiston, ME 04240-5025
Phone
(207) 783-9141
Fax
(207) 376-3808
NPI assigned
Feb 10, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 21, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X CC3842 ME Primary

Addresses

Primary practice location

1155 Lisbon St
Lewiston, ME 04240-5025

Mailing address

PO Box 2008
Lewiston, ME 04241-2008
Phone (207) 783-9141

Other identifiers 1

IdentifierTypeStateIssuer
1659559839MedicaidME

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
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
CC3842MEMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Tri-County Mental Health Services PastSince Aug 25, 2019 Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1202601600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1566345600000",
    "number": "1659559839",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2008",
            "city": "LEWISTON",
            "state": "ME",
            "postal_code": "042412008",
            "telephone_number": "207-783-9141",
            "fax_number": "207-376-3808"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1155 LISBON ST",
            "city": "LEWISTON",
            "state": "ME",
            "postal_code": "042405025",
            "telephone_number": "207-783-9141",
            "fax_number": "207-376-3808"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOSSELIN",
        "first_name": "CARRIE",
        "name_prefix": "Miss",
        "credential": "M.A., LCPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-02-10",
        "last_updated": "2019-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "ME",
            "license": "CC3842",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1659559839",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lewiston, ME

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 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.