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MARISSA JORDYN GOUGH
NPI 1891389722
Counselor in Altus, OK

Active since February 22, 2021
111 SEQUOYAH LN, ALTUS, OK 73521(580) 379-0203 Get Directions Write a Review

NPPES record last updated: April 16, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Jan 4, 2022, Feb 23, 2021 (2 updates tracked since 2021).

About Marissa Jordyn Gough NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MARISSA JORDYN GOUGH (NPI 1891389722) is an individual counselor in Altus, Oklahoma, licensed in Oklahoma (11721) and active in the NPI registry since February 2021.

NPPES Registry Identity

NPI1891389722
Entity TypeIndividualFemale
Primary Taxonomy101Y00000X
Provider Legal NameMARISSA JORDYN GOUGH
Location Address111 SEQUOYAH LNAltus, OK 73521-1756
Mailing Address111 Sequoyah LnAltus, OK 73521-1756 · (580) 379-0203
Phone(580) 379-0203
Sole ProprietorNo
Enumeration DateFebruary 22, 2021
Last NPPES UpdateApril 16, 20252 updates tracked since enumeration
NPPES CertifiedApril 16, 2025
✔ NPI 1891389722 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselorBehavioral Health & Social Service Providers
Taxonomy Code101Y00000X
License✔ Licensed in OK · 11721
Definition
A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master's degree and clinical experience and supervision for licensure or certification.
111 SEQUOYAH LN, Altus, OK 73521
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Other Names 1

Former Name (1)Marissa Jordyn Bourgeois

Other Providers at the Same Location NPPES 4

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

AMANDA JANE BERNASCONI
Case Manager/Care Coordinator
111 SEQUOYAH LN
ALTUS, OK 73521
Jackson County (580) 482-2809
JEANNE LEE BRANDON BS
Social Worker
111 SEQUOYAH LN
ALTUS, OK 73521
Jackson County (580) 482-2809
JOHN WALL
Counselor
111 SEQUOYAH LN
ALTUS, OK 73521
Jackson County (580) 482-2809
RACHEL CRUME LPC US
Counselor (Professional)
111 SEQUOYAH LN
ALTUS, OK 73521
Jackson County (580) 379-0203

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Marissa Gough's NPI number?

The NPI number for Marissa Gough is 1891389722. It was assigned to this individual provider in the NPPES registry on February 22, 2021. The provider is also known as Marissa Jordyn Bourgeois.

Where is Marissa Gough located?

Marissa Gough practices at 111 Sequoyah Ln, Altus, OK 73521. The listed phone number is (580) 379-0203.

What is Marissa Gough's specialty?

The primary specialty registered for this NPI is Counselor with taxonomy code 101Y00000X.

When was this NPI record last updated?

The NPPES record for Marissa Gough was last updated on April 16, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.