Richard Michael Gorman III, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

003630 Issued in CT

Practice address

18 Commodore Hull Dr
Derby, CT 06418-2255

Phone

(860) 830-7967

NPI assigned

Dec 26, 2018

Last updated

Dec 26, 2018By the provider in NPPES

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

Enrolled in CT

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

Specialty

Mental Health Counselor

Education

Other, 2015

Medicare assignment

May accept Medicare assignment

Group practices

Key Therapy LLCGroup PAC ID 6204185010, 9 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Key Therapy LLC

  • Marriage & Family Therapist
  • Monroe, CT
  • NPI 1114393493
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1545782400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1545782400000",
    "number": "1851863294",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18 COMMODORE HULL DR",
            "city": "DERBY",
            "state": "CT",
            "postal_code": "064182255",
            "telephone_number": "860-830-7967"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18 COMMODORE HULL DR",
            "city": "DERBY",
            "state": "CT",
            "postal_code": "064182255",
            "telephone_number": "860-830-7967"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GORMAN",
        "first_name": "RICHARD",
        "middle_name": "MICHAEL",
        "name_prefix": "Mr.",
        "name_suffix": "III",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-12-26",
        "last_updated": "2018-12-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "CT",
            "license": "003630",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lawrence Gluck, MD
• Joseph Gnanaraj, M..
• Roseanne Goldberg, R.P.T.
• Jaime Allison Goldstein, MD
• Jessica Gonzalez, PA-C
• Grade a Market Derby LLC (Shoprite Pharmacy of Derby)
• Amanda Graham, LMSW
• Carrie Anne Gray, D.M.D
• William Gray, M.D.
• Griffin Anesthesia Associates PC

• Professional Counselor in Derby, CT
• Providers in Derby, CT by specialty
• Professional Counselor in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 26, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.