Provider Demographics
NPI:1326491523
Name:GOSSAGE, ERIN (LPC)
Entity Type:Individual
Prefix:
First Name:ERIN
Middle Name:
Last Name:GOSSAGE
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:707 GITTINGS ST
Mailing Address - Street 2:SUITE #120
Mailing Address - City:SUFFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23434-6101
Mailing Address - Country:US
Mailing Address - Phone:757-514-3248
Mailing Address - Fax:757-809-5387
Practice Address - Street 1:707 GITTINGS ST
Practice Address - Street 2:SUITE #120
Practice Address - City:SUFFOLK
Practice Address - State:VA
Practice Address - Zip Code:23434-6101
Practice Address - Country:US
Practice Address - Phone:757-514-3248
Practice Address - Fax:757-514-3248
Is Sole Proprietor?:No
Enumeration Date:2016-07-22
Last Update Date:2022-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701007111101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health