Active NPI
Kathleen Carmody-Gorman, LCSW
- Clinical Social Worker
- Austin, TX
National Provider Identifier
1003962515
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 26269
- Practice address
- 5425 A Burnet Road
Austin, TX 78756 - Phone
- (512) 451-7337
- Fax
- (512) 451-8729
- NPI assigned
- Jan 26, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 26269 | TX | Primary |
Addresses
Primary practice location
5425 A Burnet Road
Austin, TX 78756
Mailing address
5425 A Burnet Road
Austin, TX 78756
Phone (512) 451-7337
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 26269 | TX | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Samaritan Center for Counseling and Pastoral Care, Inc. | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Community/Behavioral Health Agency
- Austin, TX
- NPI 1801936133
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1169769600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1185148800000",
"number": "1003962515",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5425 A BURNET ROAD",
"city": "AUSTIN",
"state": "TX",
"postal_code": "78756",
"telephone_number": "512-451-7337",
"fax_number": "512-451-8729"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5425 A BURNET ROAD",
"city": "AUSTIN",
"state": "TX",
"postal_code": "78756",
"telephone_number": "512-451-7337",
"fax_number": "512-451-8729"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CARMODY-GORMAN",
"first_name": "KATHLEEN",
"name_prefix": "Ms.",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-01-26",
"last_updated": "2007-07-23",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "TX",
"license": "26269",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Austin, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.