Provider Demographics
NPI:1174926943
Name:GOSSELIN, HEATHER K (LCSW)
Entity type:Individual
Prefix:
First Name:HEATHER
Middle Name:K
Last Name:GOSSELIN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:41 ARCTIC STATION RD
Mailing Address - Street 2:
Mailing Address - City:ORRINGTON
Mailing Address - State:ME
Mailing Address - Zip Code:04474-3013
Mailing Address - Country:US
Mailing Address - Phone:207-299-1414
Mailing Address - Fax:207-947-6278
Practice Address - Street 1:16 KIDS PEACE WAY
Practice Address - Street 2:
Practice Address - City:ELLSWORTH
Practice Address - State:ME
Practice Address - Zip Code:04605-3483
Practice Address - Country:US
Practice Address - Phone:207-664-1261
Practice Address - Fax:207-412-0612
Is Sole Proprietor?:Yes
Enumeration Date:2014-10-07
Last Update Date:2024-01-06
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
ME168371041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical