Jan Eileen Gosselin, LCPC LICENSED CLINIC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

180006181 Issued in IL

Practice address

333 Skokie Blvd
114
Northbrook, IL 60062-1613

Phone

(847) 337-5797

NPI assigned

Jan 23, 2008

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Ms. Jan Eileen Pearson Former name

Medicare fee-for-service enrollment

Enrolled in IL

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, 2003

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Patricia Kimbel PSYD PC

  • Clinical Psychologist
  • Libertyville, IL
  • NPI 1215696752
  NPD (past)

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

{
    "created_epoch": "1201046400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1450137600000",
    "number": "1861679615",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3223 W PARKWAY DR",
            "address_2": "1-G",
            "city": "NORTHBROOK",
            "state": "IL",
            "postal_code": "600627237",
            "telephone_number": "847-337-5797"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "333 SKOKIE BLVD",
            "address_2": "114",
            "city": "NORTHBROOK",
            "state": "IL",
            "postal_code": "600621613",
            "telephone_number": "847-337-5797"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOSSELIN",
        "first_name": "JAN",
        "middle_name": "EILEEN",
        "name_prefix": "Ms.",
        "credential": "LCPC LICENSED CLINIC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-01-23",
        "last_updated": "2015-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "IL",
            "license": "180006181",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JAN",
            "last_name": "PEARSON",
            "middle_name": "EILEEN",
            "prefix": "MS.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Cynthia Lee Gordon, MD
• Martine Gorstein, PSY.D.
• Michael Gortowski
• Kelly Marie Gorz, D.N.
• Joy Goscinski-Jones, RBT-19-77243
• Angela Goudschaal, MOTR
• Linda Victoria Govea, RBT-19-75718
• Jane Berkeley Graber, DENTIST
• Grace Health System, Inc.
• Therese Grady, APN

• Professional Counselor in Northbrook, IL
• Providers in Northbrook, IL by specialty
• Professional Counselor in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2015; 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.