Provider Demographics
NPI:1053068445
Name:GOSCICKI PSYCHOTHERAPY SERVICES, PLLC
Entity Type:Organization
Organization Name:GOSCICKI PSYCHOTHERAPY SERVICES, PLLC
Other - Org Name:GPS THERAPY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER / PSYCHOTHERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:TERESA
Authorized Official - Middle Name:M
Authorized Official - Last Name:GOSCICKI
Authorized Official - Suffix:
Authorized Official - Credentials:MA, LLP
Authorized Official - Phone:248-954-4837
Mailing Address - Street 1:39325 PLYMOUTH RD STE 201
Mailing Address - Street 2:
Mailing Address - City:LIVONIA
Mailing Address - State:MI
Mailing Address - Zip Code:48150-4531
Mailing Address - Country:US
Mailing Address - Phone:248-954-4837
Mailing Address - Fax:
Practice Address - Street 1:39325 PLYMOUTH RD STE 201
Practice Address - Street 2:
Practice Address - City:LIVONIA
Practice Address - State:MI
Practice Address - Zip Code:48150-4531
Practice Address - Country:US
Practice Address - Phone:248-954-4837
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-03-04
Last Update Date:2023-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Multi-Specialty