Provider Demographics
NPI:1386289858
Name:GOSSEL, COURTNEY (LCDCIII, MFT-T)
Entity type:Individual
Prefix:
First Name:COURTNEY
Middle Name:
Last Name:GOSSEL
Suffix:
Gender:F
Credentials:LCDCIII, MFT-T
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24865 US HIGHWAY 23 S
Mailing Address - Street 2:
Mailing Address - City:CIRCLEVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43113-9189
Mailing Address - Country:US
Mailing Address - Phone:740-237-3020
Mailing Address - Fax:
Practice Address - Street 1:337 E MAIN ST
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:OH
Practice Address - Zip Code:43130-3845
Practice Address - Country:US
Practice Address - Phone:740-237-3020
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-11-08
Last Update Date:2024-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHLCDCIII.162241103TA0400X
OHM.2400378-TRNE106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No103TA0400XBehavioral Health & Social Service ProvidersPsychologistAddiction (Substance Use Disorder)