Jeffrey Michael Gore, L.C.S.W.

Primary specialty

Social WorkerTaxonomy code 104100000X

License

216630 Issued in MA

Practice address

189 Glenway St
Dorchester, MA 02121-4111

Phone

(617) 388-8088

NPI assigned

Nov 9, 2010

Sex

Male

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 MA

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jeffreygore@ssmh.netsmartdirect.net

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.

• Third Space Therapy PLLC

  • Mental Health Counselor
  • Houston, TX
  • NPI 1215780234

  MA

  Medicare reassignment NPD
• South Shore Mental Health Center, Inc.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Quincy, MA
  • NPI 1770528317
  NPD
• New York State Health Medical PC

  • Mental Health Counselor
  • New York, NY
  • NPI 1043156029
  NPD (past)

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

{
    "created_epoch": "1289260800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1289260800000",
    "number": "1144521055",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "138 INDEPENDENCE AVE",
            "city": "QUINCY",
            "state": "MA",
            "postal_code": "021697724",
            "telephone_number": "617-388-8088"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "189 GLENWAY ST",
            "city": "DORCHESTER",
            "state": "MA",
            "postal_code": "021214111",
            "telephone_number": "617-388-8088"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GORE",
        "first_name": "JEFFREY",
        "middle_name": "MICHAEL",
        "name_prefix": "Mr.",
        "credential": "L.C.S.W.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-11-09",
        "last_updated": "2010-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MA",
            "license": "216630",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Norma I Gonzalez, RN
• Rosa Gonzalez
• Sam C Gonzalez, MD
• Yuisa Gonzalez
• Holly L Goodale, MD
• Sarah Rose Gottlieb, MA
• Nancy I. Gould, RN
• Virginia Ann Graham, OT
• Thiara Grandison
• Charles Granoff, LICSW

• Social Worker in Dorchester, MA
• Providers in Dorchester, MA by specialty
• Social Worker in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2010; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.