Active NPI
Rimma Gofman, LMFT
- Marriage & Family Therapist
- Bridgeport, CT
National Provider Identifier
1679938690
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- 001778
- Practice address
- 475 Clinton Ave
Bridgeport, CT 06605-1700 - Phone
- (203) 368-4291
- Fax
- (203) 368-9167
- NPI assigned
- Dec 17, 2015
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | 001778 | CT | Primary |
Addresses
Primary practice location
475 Clinton Ave
Bridgeport, CT 06605-1700
Mailing address
475 Clinton Ave
Bridgeport, CT 06605-1700
Phone (203) 368-4291
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 004069985 | Medicaid | CT |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Feb 4, 2025 through Feb 4, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 001329 | NY | MD | Art Therapist |
| 001778 | CT | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1450310400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1450310400000",
"number": "1679938690",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "475 CLINTON AVE",
"city": "BRIDGEPORT",
"state": "CT",
"postal_code": "066051700",
"telephone_number": "203-368-4291",
"fax_number": "203-368-9167"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "475 CLINTON AVE",
"city": "BRIDGEPORT",
"state": "CT",
"postal_code": "066051700",
"telephone_number": "203-368-4291",
"fax_number": "203-368-9167"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GOFMAN",
"first_name": "RIMMA",
"credential": "LMFT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2015-12-17",
"last_updated": "2015-12-17",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "CT",
"license": "001778",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "004069985",
"state": "CT"
}
],
"endpoints": [],
"other_names": []
}Other providers in Bridgeport, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.