Provider Demographics
NPI:1487872370
Name:GOSSON, ALAYNE (MS ATR-BC LCAT)
Entity type:Individual
Prefix:MS
First Name:ALAYNE
Middle Name:
Last Name:GOSSON
Suffix:
Gender:F
Credentials:MS ATR-BC LCAT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:172 BEDFORD ST
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14609-4129
Mailing Address - Country:US
Mailing Address - Phone:585-288-4454
Mailing Address - Fax:
Practice Address - Street 1:490 E. RIDGE RD
Practice Address - Street 2:ROCHESTER MENTAL HEALTH CENTER
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14621-1297
Practice Address - Country:US
Practice Address - Phone:585-922-2567
Practice Address - Fax:585-922-2646
Is Sole Proprietor?:No
Enumeration Date:2007-04-23
Last Update Date:2011-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY000285-1OtherART THERAPY LICENSE