Active NPI
Jillian Gosselin, LSW
- Mental Health Counselor
- Wyomissing, PA
National Provider Identifier
1699051938
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- SW128359
- Practice address
- 716 N Park Rd
Wyomissing, PA 19610-2912 - Phone
- (610) 375-0544
- Fax
- (610) 378-9779
- NPI assigned
- Nov 1, 2011
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | SW128359 | PA | Primary |
Addresses
Primary practice location
716 N Park Rd
Wyomissing, PA 19610-2912
Mailing address
397 Oak Ter
West Reading, PA 19611-1330
Phone (610) 207-7075
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
| License | State | Type | Specialty |
|---|---|---|---|
| SW128359 | PA | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1320105600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1320105600000",
"number": "1699051938",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "397 OAK TER",
"city": "WEST READING",
"state": "PA",
"postal_code": "196111330",
"telephone_number": "610-207-7075"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "716 N PARK RD",
"city": "WYOMISSING",
"state": "PA",
"postal_code": "196102912",
"telephone_number": "610-375-0544",
"fax_number": "610-378-9779"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GOSSELIN",
"first_name": "JILLIAN",
"name_prefix": "Mrs.",
"credential": "LSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-11-01",
"last_updated": "2011-11-01",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "PA",
"license": "SW128359",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Wyomissing, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.