Komlantse Medakpe Gossou, LBA

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

License

000169 Issued in NY

Practice address

376 Margaret St Apt B-21
Plattsburgh, NY 12901-5015

Phone

(514) 243-1354

NPI assigned

May 15, 2019

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Networks

• Healthfirst Medicare Network H9678

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.

• TG Behavioral Health Consultants Inc.

  • Early Intervention Provider Agency
  • Plattsburgh, NY
  • NPI 1780490516
  NPD Authorized official

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

{
    "created_epoch": "1557878400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1557878400000",
    "number": "1760048714",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2141",
            "city": "PLATTSBURGH",
            "state": "NY",
            "postal_code": "129010268",
            "telephone_number": "514-243-1354"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "376 MARGARET ST APT B-21",
            "city": "PLATTSBURGH",
            "state": "NY",
            "postal_code": "129015015",
            "telephone_number": "514-243-1354"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOSSOU",
        "first_name": "KOMLANTSE",
        "middle_name": "MEDAKPE",
        "credential": "LBA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-05-15",
        "last_updated": "2019-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "NY",
            "license": "000169",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Meagan Goodwin
• Eileen Mary Goralczyk, OTR/L
• Alicia Sara Jones Gorman, LMHC
• Eric Benjamin Gorman, MD
• Charlotte A Gosrich, RD, CDN
• Kelly Gowett, RD
• Rachelle A Grad, MD
• Leo A Grafstein, M.D.
• Michael John Grasic, MD
• Athena A Graves, DDS

• Behavior Analyst in Plattsburgh, NY
• Providers in Plattsburgh, NY by specialty
• Behavior Analyst in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 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.