Individual provider Active NPI

Leslie B Gohlke, LCSW-R

  • Clinical Social Worker
  • Albany, NY
National Provider Identifier
1083816938
Registry record updated Dec 2, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
046365-R Issued in NY
Practice address
251 New Karner Rd
Albany, NY 12205
Phone
(518) 496-7310
NPI assigned
Jun 4, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 2, 2019

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 046365-R NY Primary

Addresses

Primary practice location

251 New Karner Rd
Albany, NY 12205

Mailing address

251 New Karner Rd
Box 604
Albany, NY 12205-4626
Phone (518) 496-7310

Other practice location 1

251 New Karner Rd Ste 604
Albany, NY 12205-4626
Phone (518) 496-7310

Other practice location 2

251 New Karner Rd Ste 604
Albany, NY 12205-4626
Phone (518) 496-7310

Other practice location 3

85 Watervliet Ave
Albany, NY 12206-2034
Phone (518) 496-7310

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200122001070 NY Practitioner - Clinical Social Worker 2264867266 Practice locations: Albany, NY

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
046365-RNYMDClinical Social Worker
046365NYMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1180915200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1575244800000",
    "number": "1083816938",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "251 NEW KARNER RD",
            "address_2": "BOX 604",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "122054626",
            "telephone_number": "518-496-7310"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "251 NEW KARNER RD",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "12205",
            "telephone_number": "518-496-7310"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "251 New Karner Rd Ste 604",
            "address_purpose": "LOCATION",
            "city": "Albany",
            "state": "NY",
            "postal_code": "122054626",
            "country_code": "US",
            "telephone_number": "518-496-7310",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "251 New Karner Rd Ste 604",
            "address_purpose": "LOCATION",
            "city": "Albany",
            "state": "NY",
            "postal_code": "122054626",
            "country_code": "US",
            "telephone_number": "518-496-7310",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "85 Watervliet Ave",
            "address_purpose": "LOCATION",
            "city": "Albany",
            "state": "NY",
            "postal_code": "122062034",
            "country_code": "US",
            "telephone_number": "518-496-7310",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GOHLKE",
        "first_name": "LESLIE",
        "middle_name": "B",
        "credential": "LCSW-R",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-06-04",
        "last_updated": "2019-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "046365-R",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Albany, NY

Sources for this page

Verify at the official NPI Registry.