IDA MAE BOATMAN-GOUSSIOS (LPC) – Professional Counselor, NPI 1346405958
Professional Counselor
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
650 MENTAL HEALTH COUNSELOR in TN
Provider Addresses for IDA MAE BOATMAN-GOUSSIOS (LPC)
229 Hedrick Dr
Newport, TN 378212902
Phone: (423) 623-1057
Fax: (423) 625-8620
Type: Location
3222 Chestnut Hill School Rd
Dandridge, TN 377257238
Phone: (865) 509-6611
Fax: (865) 509-8811
Type: Location
111 Mockingbird Ave
Parrottsville, TN 378432741
Phone: (423) 625-1170
Fax: (423) 625-3618
Type: Location
103 Wilton Springs Rd
Newport, TN 378216405
Phone: (423) 487-2222
Fax: (423) 623-7787
Type: Location
100 Stoneforest Dr Ste 230
Woodstock, GA 301894903
Phone: (770) 389-8100
Type: Location
1413 RUSSELL AVE
JEFFERSON CITY, TN 377602562
Phone: (865) 471-5525
Type: Location
Remote Medical Services, 229, Hedrick Drive, Jaybird, Newport, Cocke County, Tennessee, 37821, United States
NEWPORT, TN 378212902
Phone: (423) 623-1057
Fax: (423) 625-8620
Type: Location
Yosemite National Park, PO box 577, Mariposa County, California, 95389, United States
NEWPORT, TN 378220577
Phone: (423) 613-3300
Fax: (423) 623-4088
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2025-01-24
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20250124003085 | I | Mental Health Counselor | TN | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 37821)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Family Practice | TN | |
| Nurse Practitioner | TN | |
| Mental Health Counselor | TN | |
| Nurse Practitioner | TN | |
| - | TN | |
| - | TN | |
| - | TN | |
| Nurse Practitioner | TN | |
| Nurse Practitioner | TN | |
| Mental Health Counselor | TN |
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