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Individual

MR. GARY W GOSSAGE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MSW, LCSW

Contact information

Practice address
1910 PAYTON CIRCLE, COLORADO SPRINGS, CO 80915-1327
(701) 400-2592
(719) 637-1554
Mailing address
1910 PAYTON CIRCLE, COLORADO SPRINGS, CO 80915-1327
(701) 400-2592
(719) 637-1554

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
984016
CO
1041C0700X
Clinical Social Worker
Primary
CSW00984016
CO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
37220241
CO
Enumeration date
01/17/2007
Last updated
08/21/2019
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