Active NPI
Carla Denise McGowan, LCSW
- Clinical Social Worker
- Jackson, MS
National Provider Identifier
1114467495
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- C5523
- Practice address
- 3048 Bienville Dr
Jackson, MS 39212-2540 - Phone
- (601) 946-3256
- NPI assigned
- Mar 6, 2017
- Sex
- Female
- Sole proprietor
- Yes
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 | C5523 | MS | Primary |
Addresses
Primary practice location
3048 Bienville Dr
Jackson, MS 39212-2540
Mailing address
3048 Bienville Dr
Jackson, MS 39212-2540
Phone (601) 946-3256
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 |
|---|---|---|---|
| C5523 | MS | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Teladoc Health Medical Group, P.a. | Clinical | Current | Accepting new patients |
Interoperability endpoints
- carlamcgowan@tdh.allscriptsdirect.net
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": "1488758400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1488758400000",
"number": "1114467495",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3048 BIENVILLE DR",
"city": "JACKSON",
"state": "MS",
"postal_code": "392122540",
"telephone_number": "601-946-3256"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3048 BIENVILLE DR",
"city": "JACKSON",
"state": "MS",
"postal_code": "392122540",
"telephone_number": "601-946-3256"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCGOWAN",
"first_name": "CARLA",
"middle_name": "DENISE",
"name_prefix": "Mrs.",
"credential": "LCSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2017-03-06",
"last_updated": "2017-03-06",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "MS",
"license": "C5523",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Jackson, MS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 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.