Individual provider · Type 1 NPI

Ida Mae Boatman-Goussios, LPC

Professional Counselor · Jefferson City, TN

NPI number 1346405958 Active

Practice location

1413 Russell Ave
Jefferson City, TN 37760-2562

Call (865) 471-5525 Map

Mailing address

PO Box 577
Newport, TN 37822-0577

Other practice locations

  • 229 Hedrick Dr, Newport, TN 37821-2902 · (423) 623-1057
  • 3222 Chestnut Hill School Rd, Dandridge, TN 37725-7238 · (865) 509-6611
  • 103 Wilton Springs Rd, Newport, TN 37821-6405 · (423) 487-2222
  • 111 Mockingbird Ave, Parrottsville, TN 37843-2741 · (423) 625-1170
  • 100 Stoneforest Dr Ste 230, Woodstock, GA 30189-4903 · (770) 389-8100

Specialties and licenses

TaxonomyCodeLicense
Professional Counselor 101YP2500XLPC013160 (GA)
Professional Counselor Primary 101YP2500X2267 (TN)

Professional Counselor: Definition to come...

7 other providers at this address

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About NPI 1346405958

Ida Mae Boatman-Goussios, LPC's National Provider Identifier is 1346405958, issued on Jul 23, 2008. The primary taxonomy on file is Professional Counselor (101YP2500X), and the practice location is in Jefferson City, TN. The record was last updated on Jan 2, 2025.