Individual provider Active NPI

Paul Gonsoulin, LPC

  • Mental Health Counselor
  • Lake Charles, LA
National Provider Identifier
1700313467
Registry record updated Mar 14, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
7548 Issued in LA
Practice address
833 Hodges St
Lake Charles, LA 70601-4247
Phone
(337) 502-9497
NPI assigned
May 12, 2017
Last updated
Mar 14, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 14, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X
Mental Health Counselor 101YM0800X 7548 LA Primary

Addresses

Primary practice location

833 Hodges St
Lake Charles, LA 70601-4247

Mailing address

412 Woodruff St
Lake Charles, LA 70601-5860
Phone (337) 794-3497

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260606000265 LA Practitioner - Mental Health Counselor 0547731945 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2018
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

4816 Ogden Rd
Lake Charles, LA 70605-3918

PO Box
Suite 712260
Salt Lake City, UT 84171

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
7548LAMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Roots Counseling LLC Mental Health CurrentSince Jan 1, 2023 Accepting new patients
Counseling Services of Southwest Louisiana, Inc. Mental Health PastSince Mar 21, 2019 Accepting new patients
Disney & Associates, Inc Mental Health Past Accepting new patients

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1494547200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678752000000",
    "number": "1700313467",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "412 WOODRUFF ST",
            "city": "LAKE CHARLES",
            "state": "LA",
            "postal_code": "706015860",
            "telephone_number": "337-794-3497"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "833 HODGES ST",
            "city": "LAKE CHARLES",
            "state": "LA",
            "postal_code": "706014247",
            "telephone_number": "337-502-9497"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GONSOULIN",
        "first_name": "PAUL",
        "name_prefix": "Mr.",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-05-12",
        "last_updated": "2023-03-14",
        "certification_date": "2023-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "LA",
            "license": "7548",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Charles, LA

Sources for this page

Verify at the official NPI Registry.