Clinical Consultation & Counseling, P.a.

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

Legal business name

CLINICAL CONSULTATION & COUNSELING, P.A.

Doing business as

Clinical Consultation & Counseling

Practice address

26 River St
2ND Floor
Dover Foxcroft, ME 04426-1321

Phone

(207) 564-0026

Fax

(877) 822-7919

NPI assigned

Apr 30, 2010

Last updated

Apr 30, 2010By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

David Arthur Goolsby, LCSWNPI 1588664163

Title

President

Phone

(207) 564-0026

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Clinical Consultation & Counseling Doing business as

Medicare fee-for-service enrollment

Enrolled in ME

Enrollment records 1

Locations

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• David Arthur Goolsby, LCSW

  • Clinical Social Worker
  • Lincoln, ME
  • NPI 1588664163
  Medicare reassignment Care Compare group NPD Authorized official
• Mary Catherine Goolsby, LCSW

  • Clinical Social Worker
  • Lincoln, ME
  • NPI 1902024870
  Medicare reassignment Care Compare group NPD
• Verna Jo Boyington, LCPCC

  • Professional Counselor
  • Lincoln, ME
  • NPI 1144547084
  NPD (past)
• Alyssa Mercedes Gleason

  • Community/Behavioral Health Agency
  • Lincoln, ME
  • NPI 1306608005
  NPD (past)

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

{
    "created_epoch": "1272585600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1272585600000",
    "number": "1831416783",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 370",
            "city": "DOVER FOXCROFT",
            "state": "ME",
            "postal_code": "044260370",
            "telephone_number": "207-564-0026",
            "fax_number": "877-822-7919"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26 RIVER ST",
            "address_2": "2ND FLOOR",
            "city": "DOVER FOXCROFT",
            "state": "ME",
            "postal_code": "044261321",
            "telephone_number": "207-564-0026",
            "fax_number": "877-822-7919"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLINICAL CONSULTATION & COUNSELING, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-04-30",
        "last_updated": "2010-04-30",
        "status": "A",
        "authorized_official_last_name": "GOOLSBY",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "ARTHUR",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "207-564-0026",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "431819099",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Clinical Consultation & Counseling",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Kathleen Childs, FNP
• Kassandra Alyssa Churchill
• John Warren Clark, DDS
• Felicia Cleaves, RN
• Tanya L Clement, PT, DPT
• Christopher Robert Clukey, M.A.CCC-A
• Jeffrey Allen Cole, DO
• Lauren Colley, PTA
• Jason Lee Comeau, APRN-CNP
• Emma Diane Comp

• Mental Health Clinic/Center (Including Community Mental Health Center) in Dover Foxcroft, ME
• Providers in Dover Foxcroft, ME by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.