Provider Demographics
NPI:1932444684
Name:GOSEN, NICOLA MARGARET (MA, MFT)
Entity Type:Individual
Prefix:MS
First Name:NICOLA
Middle Name:MARGARET
Last Name:GOSEN
Suffix:
Gender:F
Credentials:MA, MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:930 13TH ST
Mailing Address - Street 2:
Mailing Address - City:BELLINGHAM
Mailing Address - State:WA
Mailing Address - Zip Code:98225-6221
Mailing Address - Country:US
Mailing Address - Phone:805-680-2621
Mailing Address - Fax:
Practice Address - Street 1:930 13TH ST
Practice Address - Street 2:
Practice Address - City:BELLINGHAM
Practice Address - State:WA
Practice Address - Zip Code:98225-6221
Practice Address - Country:US
Practice Address - Phone:805-680-2621
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-12-06
Last Update Date:2015-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC47444106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist