Healthcare Provider Details

I. General information

NPI: 1194108571
Provider Name (Legal Business Name): MEAGHAN LEIGH GOSLING LPCC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/03/2015
Last Update Date: 11/20/2020
Certification Date: 11/20/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9605 LORD DR
WINDSOR CA
95492-8045
US

IV. Provider business mailing address

9605 LORD DR
WINDSOR CA
95492-8045
US

V. Phone/Fax

Practice location:
  • Phone: 707-593-6333
  • Fax:
Mailing address:
  • Phone: 707-593-6333
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberLPCC7805
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: