MS. MARY LARISSA GORMAN (NPI# 1790078517) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1790078517 |
| Entity Type | Individual |
| Full Name | MS. MARY LARISSA GORMAN |
| Credential | MA, LADC |
| Practice Address |
135 Colorado St E Saint Paul MN 55107-2244 |
| Practice Telephone | 6514897740 |
| Practice Fax Number | 6514896458 |
| Mailing Telephone | 6514897740 |
| Mailing Fax Number | 6514896458 |
| Enumeration Date | 2011-05-26 |
| Last Update Date | 2011-05-26 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
302977 | MN | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861555096 | Mary Beck Gorman | Anesthesiology | 137 W Lee St, Baltimore, MD 21201-2420 | 2006-12-19 |
| 1073606828 | Mary Gorman | Physical Therapist | 309 S Pacific Hwy, Talent, OR 97540-6650 | 2006-10-02 |
| 1477663573 | Mary Sloan Gorman | Social Worker | 205 Keller St Ste 202c, Petaluma, CA 94952-2878 | 2006-08-30 |
| 1710925359 | Mary G Gorman | Emergency Medicine | 723 Hill Country Dr Ste C, Kerrville, TX 78028-6043 | 2006-06-04 |
| 1205807286 | Mary Gorman | Nurse Practitioner | 4967 Crooks Rd Ste 130, Troy, MI 48098-5812 | 2006-01-30 |
| 1316370281 | Mary Ellen Gorman | Registered Nurse | 2215 Fuller Rd, Ann Arbor, MI 48105-2303 | 2013-08-15 |
| 1063636041 | Mary Elizabeth Gorman | Otolaryngology | 1221 Mercantile Ln, Largo, MD 20774-5374 | 2007-04-12 |
| 1386688026 | Mary Elizabeth Gorman | Nurse Anesthetist, Certified Registered | 234 Goodman St, Cincinnati, OH 45219-2364 | 2006-06-15 |
| 1346289832 | Mary A Gorman | Nurse Practitioner | 10 Gove St, East Boston, MA 02128-1920 | 2006-06-06 |
| 1235176538 | Mary Ellen Gorman | Registered Nurse | 42 Washington St, Suite 210, Wellesley, MA 02481 | 2006-06-02 |
| Street Address |
135 COLORADO ST E |
| City | SAINT PAUL |
| State | MN |
| Zip Code | 55107-2244 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558652925 | Tapestry | Substance Abuse Rehabilitation Facility | 135 Colorado St E, Saint Paul, MN 55107-2244 | 2011-04-20 |
| 1124677372 | Andrea Susan Kofoed | Counselor | 135 Colorado St E, Saint Paul, MN 55107-2244 | 2019-09-10 |
| 1023427226 | Janel Oberg | Substance Abuse Rehabilitation Facility | 135 Colorado St E, Saint Paul, MN 55107-2244 | 2014-08-13 |
| 1740699164 | Laura Pohlman | Counselor | 135 Colorado St E, Saint Paul, MN 55107-2244 | 2014-08-11 |
| 1275949299 | Shannon Swarthout | Substance Abuse Rehabilitation Facility | 135 Colorado St E, Saint Paul, MN 55107-2244 | 2014-07-10 |
| 1992061311 | Meridian Behavioral Health | Community/Behavioral Health | 135 Colorado St E, Saint Paul, MN 55107-2244 | 2012-04-10 |
| 1275828337 | Seika Noguchi Charpentier | Counselor | 135 Colorado St E, Saint Paul, MN 55107-2244 | 2011-06-16 |
| 1982997722 | Connie Lou Bingel Bombenger | Counselor | 135 Colorado St E, Saint Paul, MN 55107-2244 | 2011-05-26 |
| 1801189600 | Terry Rose Katusky | Counselor | 135 Colorado St E, Saint Paul, MN 55107-2244 | 2011-05-26 |
| 1013200856 | Melodee Jean Benson | Counselor | 135 Colorado St E, Saint Paul, MN 55107-2244 | 2011-05-26 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477944809 | Marina Castillo | Counselor | 143 Isabel St. W, Saint Paul, MN 55107 | 2015-02-06 |
| 1134540123 | Michelle M Lee | Social Worker | 106 Water Street/3rd Floor, Umbrella Tree Studios, St. Paul, MN 55107 | 2013-12-18 |
| 1376748574 | Mary E. A. Horoshak | Physical Therapist | 155 S Wabasha St, Suite 130, St. Paul, MN 55107 | 2007-06-18 |
| 1821156050 | Amherst H. Wilder Foundation | Assisted Living Facility | 469 Ada St, Saint Paul, MN 55107 | 2006-12-04 |
| 1407914674 | Amherst H. Wilder Foundation | Clinic/Center | 516 Humboldt Ave, Saint Paul, MN 55107 | 2006-12-04 |
| 1780753681 | Chad Randal Vickers | Nurse Practitioner | 135 Colorado Street East, Saint Paul, MN 55107 | 2006-11-06 |
| 1225122872 | Elizabeth E Frost | Family Medicine | 153 Cesar Chavez Street, St Paul, MN 55107 | 2006-10-03 |
| 1215457890 | Elizabeth Smith Zaremba | Dietitian, Registered | 205 Wabasha St S, Mail Stop 31300a, St Paul, MN 55107 | 2017-06-23 |
| 1619413606 | Elizabeth Burgos | Social Worker | 153 Cesar Chavez St, Saint Paul, MN 55107 | 2017-01-13 |
| 1033561915 | Isetta Pierre | Marriage & Family Therapist | 153 Cesar Chavez St, Saint Paul, MN 55107 | 2016-07-05 |
| Find all providers in zip 55107 | ||||
| Taxonomy Code | 101YA0400X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Addiction (Substance Use Disorder) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235736786 | Catherine Ann Jaksha | Counselor | 1180 Cushing Cir Apt 217, Saint Paul, MN 55108-5016 | 2020-10-07 |
| 1629683388 | Family Recovery Resource Experts LLC | Counselor | 311 Ramsey St Ste 206, Saint Paul, MN 55102-2323 | 2020-09-10 |
| 1811508120 | Damaris Axelson | Counselor | 69 Exchange St W # G700, Saint Paul, MN 55102-1004 | 2020-08-11 |
| 1366051344 | Carrie Lois Sorenson | Counselor | 1618 Dayton Ave, Saint Paul, MN 55104-6207 | 2020-07-27 |
| 1104452564 | Heather Thurmes | Counselor | 555 7th St W Ste 302, Saint Paul, MN 55102-3068 | 2020-03-18 |
| 1396377206 | Gail Weiss | Counselor | 1821 University Ave W Ste 333, Saint Paul, MN 55104-2895 | 2020-02-08 |
| 1104456573 | Sarah Ann Licari | Counselor | 455 Etna St, Saint Paul, MN 55106-5859 | 2020-01-24 |
| 1881230134 | Gregory John Robertson | Counselor | 1380 Energy Ln Ste 203, Saint Paul, MN 55108-5253 | 2019-11-21 |
| 1225671415 | Sukimo Dolores Knight | Counselor | 1606 Westminster St # 312, Saint Paul, MN 55130-3036 | 2019-10-21 |
| 1194374850 | Justin Crawford Diehl | Counselor | 976 Juno Avenue, Saint Paul, MN 55102 | 2019-09-05 |
| Find all providers in SAINT PAUL | ||||
| City | SAINT PAUL |
| Zip Code | 55107 |
Please comment or provide details below to improve the information on MS. MARY LARISSA GORMAN.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.