Individual provider Active NPI

Patricia A Gore, LCSW, LICSW

  • Social Worker
  • Maxwelton, WV
National Provider Identifier
1093875734
Registry record updated Apr 20, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
CP00938611 Issued in WV
Practice address
804 Industrial Park Rd
Maxwelton, WV 24957-8066
Phone
(304) 497-0500
Fax
(304) 497-0516
NPI assigned
Dec 11, 2006
Last updated
Apr 20, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 20, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X CP00938611 WV Primary
Clinical Social Worker 1041C0700X DP00938611 WV

Addresses

Primary practice location

804 Industrial Park Rd
Maxwelton, WV 24957-8066

Mailing address

131 Wellness Dr
Summersville, WV 26651-5402
Phone (304) 872-6503

Other practice location 1

704 3rd Ave
Marlinton, WV 24954-1142
Phone (304) 799-6865

Other practice location 2

70 Parcoal Rd
Webster Springs, WV 26288-9767
Phone (304) 847-5425

Other practice location 3

131 Wellness Dr
Summersville, WV 26651-5402
Phone (304) 872-2659

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV
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
I20040510001463 WV Practitioner - Clinical Social Worker 6305835737 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Seneca Health Services IncGroup PAC ID 8022005263, 16 clinicians

Practice addresses (Care Compare)

804 Industrial Park Rd
Maxwelton, WV 24957-8066
Phone (888) 736-3223

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Seneca Health Services Inc Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1165795200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1650412800000",
    "number": "1093875734",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "131 WELLNESS DR",
            "city": "SUMMERSVILLE",
            "state": "WV",
            "postal_code": "266515402",
            "telephone_number": "304-872-6503",
            "fax_number": "304-872-5415"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "804 INDUSTRIAL PARK RD",
            "city": "MAXWELTON",
            "state": "WV",
            "postal_code": "249578066",
            "telephone_number": "304-497-0500",
            "fax_number": "304-497-0516"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "704 3rd Ave",
            "address_purpose": "LOCATION",
            "city": "Marlinton",
            "state": "WV",
            "postal_code": "249541142",
            "country_code": "US",
            "telephone_number": "304-799-6865",
            "fax_number": "304-799-6878",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "70 Parcoal Rd",
            "address_purpose": "LOCATION",
            "city": "Webster Springs",
            "state": "WV",
            "postal_code": "262889767",
            "country_code": "US",
            "telephone_number": "304-847-5425",
            "fax_number": "304-847-5422",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "131 Wellness Dr",
            "address_purpose": "LOCATION",
            "city": "Summersville",
            "state": "WV",
            "postal_code": "266515402",
            "country_code": "US",
            "telephone_number": "304-872-2659",
            "fax_number": "304-872-1685",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GORE",
        "first_name": "PATRICIA",
        "middle_name": "A",
        "credential": "LCSW, LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-11",
        "last_updated": "2022-04-20",
        "certification_date": "2022-04-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "WV",
            "license": "CP00938611",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WV",
            "license": "DP00938611",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Maxwelton, WV

Sources for this page

Verify at the official NPI Registry.