Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Ida Mae Boatman-Goussios, LPC

Individual provider Professional Counselor · NPI 1346405958

Ida Mae Boatman-Goussios, LPC is a Mental Health Counselor in Jefferson City, Tennessee. Qualified in 2002, 24 years ago. Practices with Rural Medical Services, Inc, a 20-clinician group, works from 6 locations and accepts Medicare assignment. Licensed in Georgia and Tennessee.

Years since qualifying
24
Licensed in
GA, TN
In the registry since
2008
Specialties on file
2
What do these letters mean?
LPC — Licensed Professional Counselor
A licensed mental health counsellor.

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Practice location Address checks out

1413 Russell Ave
Jefferson City, TN 37760-2562
Phone: (865) 471-5525
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (5)

  • 100 Stoneforest Dr Ste 230, Woodstock, GA 30189-4903 — (770) 389-8100
  • 3222 Chestnut Hill School Rd, Dandridge, TN 37725-7238 — (865) 509-6611
  • 229 Hedrick Dr, Newport, TN 37821-2902 — (423) 623-1057
  • 103 Wilton Springs Rd, Newport, TN 37821-6405 — (423) 487-2222
  • 111 Mockingbird Ave, Parrottsville, TN 37843-2741 — (423) 625-1170

Specialties & licences

Professional Counselor (primary) Taxonomy 101YP2500X · Licence 2267 (TN)
Professional Counselor Taxonomy 101YP2500X · Licence LPC013160 (GA)

Record details

NPI number1346405958
Entity typeIndividual (Type 1)
GenderFemale
Credentials LPC
Sole proprietorNo
NPI enumeratedJuly 23, 2008
Last updated in NPPESJanuary 2, 2025
Certification dateJanuary 2, 2025

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyMENTAL HEALTH COUNSELOR
Medical schoolOTHER
Graduated 2002 (24 years in practice)
Group practice Rural Medical Services, Inc. — 20 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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