Marilyn A Gora Fong, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Practice address

12 Sarah St
Providence, RI 02906-2821

Phone

(508) 235-7337

NPI assigned

Jan 11, 2007

Last updated

Jan 2, 2025By the provider in NPPES

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 RI

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, 1983

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

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.

• MG Therapy LLC

  • Mental Health Counselor
  • Cranston, RI
  • NPI 1093576530
  NPD (past)

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

{
    "created_epoch": "1168473600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1735776000000",
    "number": "1174673412",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12 SARAH ST",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029062821",
            "telephone_number": "401-258-8312"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12 SARAH ST",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029062821",
            "telephone_number": "508-235-7337"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GORA FONG",
        "first_name": "MARILYN",
        "middle_name": "A",
        "name_prefix": "Ms.",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-11",
        "last_updated": "2025-01-02",
        "certification_date": "2025-01-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alexandra Meditch Campbell Goodwin
• Emily Beth Goodwin, M.D.
• Sarrah Goodwin
• Eva Goodyear, DPT
• Sheena Gopal, DPT
• Mikhail Mikhailovich Gorbounov, MD
• Irina Gorbounova, M.D.
• James Gordon, PA
• Kristin Gordon, RN
• Paul C Gordon, MD

• Clinical Social Worker in Providence, RI
• Providers in Providence, RI by specialty
• Clinical Social Worker in Rhode Island

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 2, 2025; 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.