Active NPI
Kristin Gorman, PCC
- Counselor
- Middletown, OH
National Provider Identifier
1871933713
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counselor
- License
- E.0900219
- Practice address
- 1659 S Breiel Blvd
Middletown, OH 45044-6705 - Phone
- (513) 424-0921
- Fax
- (513) 424-4810
- NPI assigned
- Jun 25, 2013
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | E.0900219 | OH | Primary |
Addresses
Primary practice location
1659 S Breiel Blvd
Middletown, OH 45044-6705
Mailing address
1659 S Breiel Blvd
Middletown, OH 45044-6705
Phone (513) 424-0921
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OH
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20260403000717 | OH | Practitioner - Mental Health Counselor | 5799260014 | Practice locations: Hamilton, OH |
Care Compare profile
Medicare Care Compare- Specialty
- Mental Health Counselor
- Education
- Other, 2010
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
100 S 3Rd St
Hamilton, OH 45011-2816
Phone (513) 518-4818
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| E.0900219 | OH | MD | Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1372118400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1372118400000",
"number": "1871933713",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1659 S BREIEL BLVD",
"city": "MIDDLETOWN",
"state": "OH",
"postal_code": "450446705",
"telephone_number": "513-424-0921",
"fax_number": "513-424-4810"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1659 S BREIEL BLVD",
"city": "MIDDLETOWN",
"state": "OH",
"postal_code": "450446705",
"telephone_number": "513-424-0921",
"fax_number": "513-424-4810"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GORMAN",
"first_name": "KRISTIN",
"credential": "PCC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-06-25",
"last_updated": "2013-06-25",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": "OH",
"license": "E.0900219",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Middletown, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2013; 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.