Provider Demographics
NPI:1043796725
Name:ERIN GOSS, LPC, LADC, PLLC
Entity Type:Organization
Organization Name:ERIN GOSS, LPC, LADC, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ERIN
Authorized Official - Middle Name:
Authorized Official - Last Name:GOSS
Authorized Official - Suffix:
Authorized Official - Credentials:LPC, LADC
Authorized Official - Phone:918-683-8827
Mailing Address - Street 1:215 STATE ST STE 401
Mailing Address - Street 2:
Mailing Address - City:MUSKOGEE
Mailing Address - State:OK
Mailing Address - Zip Code:74401-6626
Mailing Address - Country:US
Mailing Address - Phone:918-683-8827
Mailing Address - Fax:
Practice Address - Street 1:215 STATE ST STE 401
Practice Address - Street 2:
Practice Address - City:MUSKOGEE
Practice Address - State:OK
Practice Address - Zip Code:74401-6626
Practice Address - Country:US
Practice Address - Phone:918-683-8827
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-07-16
Last Update Date:2022-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty