Active NPI
David Gougelet
- Clinical Social Worker
- Tarrytown, NY
National Provider Identifier
1154936409
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 090121
- Practice address
- 475 Munroe Ave
Tarrytown, NY 10591-1441 - Phone
- (914) 221-7478
- NPI assigned
- Sep 14, 2020
- Sex
- Male
- 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 | 090121 | NY | Primary |
Addresses
Primary practice location
475 Munroe Ave
Tarrytown, NY 10591-1441
Mailing address
475 Munroe Ave
Tarrytown, NY 10591-1441
Phone (914) 221-7478
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 090121 | NY | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1600041600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1600041600000",
"number": "1154936409",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "475 MUNROE AVE",
"city": "TARRYTOWN",
"state": "NY",
"postal_code": "105911441",
"telephone_number": "914-221-7478"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "475 MUNROE AVE",
"city": "TARRYTOWN",
"state": "NY",
"postal_code": "105911441",
"telephone_number": "914-221-7478"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GOUGELET",
"first_name": "DAVID",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2020-09-14",
"last_updated": "2020-09-14",
"certification_date": "2020-09-14",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "NY",
"license": "090121",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tarrytown, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.