Individual provider Active NPI

Mark P Gorey, LSW

  • Clinical Social Worker
  • Toledo, OH
National Provider Identifier
1033638226
Registry record updated Sep 19, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
S.1000851 Issued in OH
Practice address
1776 Tremainsville Rd
Toledo, OH 43613-4039
Phone
(419) 214-0606
NPI assigned
Sep 19, 2017
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 19, 2017

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X S.1000851 OH Primary

Addresses

Primary practice location

1776 Tremainsville Rd
Toledo, OH 43613-4039

Mailing address

1776 Tremainsville Rd
Toledo, OH 43613-4039
Phone (419) 214-0606

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
S.1000851OHMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
A Renewed Mind 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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1505779200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1505779200000",
    "number": "1033638226",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1776 TREMAINSVILLE RD",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436134039",
            "telephone_number": "419-214-0606"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1776 TREMAINSVILLE RD",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436134039",
            "telephone_number": "419-214-0606"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOREY",
        "first_name": "MARK",
        "middle_name": "P",
        "credential": "LSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-09-19",
        "last_updated": "2017-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "S.1000851",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Toledo, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.