Jene Gould, LCSW-C, CCTP

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

20126 Issued in MD

Practice address

1401 Mercantile LN Ste 485
Largo, MD 20774-4301

Phone

(301) 615-1911

NPI assigned

Jul 15, 2014

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in DC

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

Specialty

Clinical Social Worker

Education

Other, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Mending Minds Wellness Center

  • Clinical Social Worker
  • Largo, MD
  • NPI 1114584091

  DC

  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1405382400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1565654400000",
    "number": "1114334893",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1401 MERCANTILE LN STE 485",
            "city": "LARGO",
            "state": "MD",
            "postal_code": "207744301",
            "telephone_number": "301-615-1911"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1401 MERCANTILE LN STE 485",
            "city": "LARGO",
            "state": "MD",
            "postal_code": "207744301",
            "telephone_number": "301-615-1911"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9475 Lottsford Rd",
            "address_2": "Suite 250",
            "address_purpose": "LOCATION",
            "city": "Largo",
            "state": "MD",
            "postal_code": "207745357",
            "country_code": "US",
            "telephone_number": "301-636-6504 x705",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GOULD",
        "first_name": "JENE",
        "name_prefix": "Ms.",
        "credential": "LCSW-C, CCTP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-07-15",
        "last_updated": "2019-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MD",
            "license": "20126",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Good Health Nutrition Services LLC
• Angela Goodwin, PHARMD
• David A Gooray, MD
• Lisa Gordon, MSW, LCSW-C, LICSW
• Natalie Gospodinoff, MD
• Catherine E. Graham, PSY.D.
• Virgil Lee Graham, MD
• Lorette Gray, LCSW-C
• Geoffrey Edward Greene, MD
• Patty Greene, PHARMD

• Clinical Social Worker in Largo, MD
• Providers in Largo, MD by specialty
• Clinical Social Worker in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.