| Nicholas Gaughan, LPC | |
|
70 Main St, Griswold, CT 06351-2226 | |
| (860) 634-0967 | |
| Not Available |
| Full Name | Nicholas Gaughan |
|---|---|
| Gender | Male |
| Speciality | Counselor - Professional |
| Location | 70 Main St, Griswold, Connecticut |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1093071136 | NPI | - | NPPES |
| 1066 | Other | CT | LADC |
| 2682 | Other | CT | LPC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | 001066 (Connecticut) | Secondary |
| 101YP2500X | Counselor - Professional | 2682 (Connecticut) | Primary |
| Entity Name | Community Health Resources, Inc. |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1215979810 PECOS PAC ID: 5597652149 Enrollment ID: O20040301000155 |
| Entity Name | Life's Journey Counseling Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1285239228 PECOS PAC ID: 6507208758 Enrollment ID: O20240521000080 |
| Mailing Address | Practice Location Address |
|---|---|
| Nicholas Gaughan, LPC Po Box 296, Rogers, CT 06263-0296 Ph: (860) 634-0967 | Nicholas Gaughan, LPC 70 Main St, Griswold, CT 06351-2226 Ph: (860) 634-0967 |
Mrs. Karleigh Chase, Counselor Medicare: Not Enrolled in Medicare Practice Location: 70 Main St, Griswold, CT 06351 Phone: 860-303-9760 | |
Brian Carberg, LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 14 Nowakowski Rd, Griswold, CT 06351 Phone: 860-376-3031 | |
Kennyshka Kouwenhoven, LPC-A Counselor Medicare: Medicare Enrolled Practice Location: 70 Main St, Griswold, CT 06340 Phone: 860-469-0508 | |
Miss Cara Vaslet, BS, LCDP, LCDC III Counselor Medicare: Not Enrolled in Medicare Practice Location: 167 Bishop Crossing Rd, Griswold, CT 06351 Phone: 860-865-8492 | |
Kathleen Bradley, LPC Counselor Medicare: Medicare Enrolled Practice Location: 226 E Main St, Griswold, CT 06351 Phone: 860-376-7040 Fax: 860-376-7045 | |
Leslie Anne Stasko, LPC-A Counselor Medicare: Not Enrolled in Medicare Practice Location: 70 Main St, Griswold, CT 06351 Phone: 860-303-9760 |