Individual Healthcare Provider
Ida Mae Boatman-Goussios, LPC
Provider's NPPES record last updated: January 2, 2025
Overview
- Entity Type
- Individual Healthcare Provider
- NPI
- 1346405958
- Primary Specialty
- Counselor — Professional
- Practice Location
- Jefferson City, Tennessee
- Sole Proprietor
- No
Federal Screening
NPISignal checked this NPI against federal exclusion sources. Results below are based on the NPI number itself — an identifier match, not a name match.
List of Excluded Individuals/Entities (LEIE)
HHS Office of Inspector General
No potential match was identified in NPISignal's indexed List of Excluded Individuals/Entities (LEIE) records as of 2026-09-10.
- Source data
- September 10, 2026
- Records indexed
- 84,001
- Screened
- Sep 20, 2026, 5:32 AM UTC
This reflects only the records NPISignal currently holds and the identity information supplied. It is not a verification of eligibility, licensure, or compliance. Verify decisions that matter against the authoritative source.
SAM.gov Exclusions
U.S. General Services Administration
SAM.gov Exclusions was not checked.
SAM.gov screening is not configured on this deployment. No SAM check has been performed.
- Screened
- Not checked
This is an NPI-based check only. NPISignal does not publish name-based exclusion matches on a provider profile. A shared or similar name is a lead that requires human review, not an identification, and this page is not the place to make one. Run a name-based screening below to see potential matches with the reasons for each.
This reflects only the records NPISignal currently holds and the identity information supplied. It is not a verification of eligibility, licensure, or compliance. Verify decisions that matter against the authoritative source.
Searches OIG LEIE and SAM.gov by name and reviews every potential match.
Specialties & Taxonomies
- Primary
Counselor
Professional
Behavioral Health & Social Service Providers
Definition to come...
Taxonomy code 101YP2500X
Provider-Reported License Information
- Counselor (Tennessee)
- 2267
- Counselor (Georgia)
- LPC013160
Practice Locations
Practice Location
1413 Russell Ave
Jefferson City, Tennessee 37760-2562
Phone: (865) 471-5525
Additional Practice Location
229 Hedrick Dr
Newport, Tennessee 37821-2902
Phone: (423) 623-1057
Fax: (423) 625-8620
Additional Practice Location
111 Mockingbird Ave
Parrottsville, Tennessee 37843-2741
Phone: (423) 625-1170
Fax: (423) 625-3618
Additional Practice Location
3222 Chestnut Hill School Rd
Dandridge, Tennessee 37725-7238
Phone: (865) 509-6611
Fax: (865) 509-8811
Additional Practice Location
103 Wilton Springs Rd
Newport, Tennessee 37821-6405
Phone: (423) 487-2222
Fax: (423) 623-7787
Additional Practice Location
100 Stoneforest Dr Ste 230
Woodstock, Georgia 30189-4903
Phone: (770) 389-8100
Record Information
- Enumeration Date
- July 23, 2008
- Provider's NPPES Record Last Updated
- January 2, 2025
- Certification Date
- January 2, 2025
- NPISignal NPPES Dataset
- August 2026
See Something Wrong?
Incorrect provider information
Everything on this page comes directly from the NPPES data CMS publishes. NPISignal cannot edit a provider's record — only the provider or organization can, directly through NPPES.
Update a record through NPPESSomething wrong with this page?
If NPISignal is displaying this data incorrectly — a formatting error, a broken link, a mismatch with the source file — let us know.
Report a display issue