Jane B Gotshalk, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

LICSW113296 Issued in MA

Practice address

109 Courage Loop
Fort Stewart, GA 31315-5906

Phone

(706) 315-9407

NPI assigned

May 18, 2007

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

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1179446400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715904000000",
    "number": "1174731509",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "109 COURAGE LOOP",
            "city": "FORT STEWART",
            "state": "GA",
            "postal_code": "313155906",
            "telephone_number": "706-315-9407"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "109 COURAGE LOOP",
            "city": "FORT STEWART",
            "state": "GA",
            "postal_code": "313155906",
            "telephone_number": "706-315-9407"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "929 Massachusetts Ave Ste M03",
            "address_purpose": "LOCATION",
            "city": "Cambridge",
            "state": "MA",
            "postal_code": "021393143",
            "country_code": "US",
            "telephone_number": "855-284-7483",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GOTSHALK",
        "first_name": "JANE",
        "middle_name": "B",
        "name_prefix": "Ms.",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-18",
        "last_updated": "2024-05-17",
        "certification_date": "2024-05-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "LICSW113296",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1309587",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Thomas Patrick Goodman
• Scott Gordon Goodrich, D.O.
• Michelle Gore, RN
• Thomas Gorman, EMT
• Robert Gossett
• Marissa Rene Gouveia, PA-C
• Danielle Graber, RN
• Aerial Graham, LCSW
• Tamara Grandia
• Daniel Hicky Grant, ED. D.

• Clinical Social Worker in Fort Stewart, GA
• Providers in Fort Stewart, GA by specialty
• Clinical Social Worker in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 17, 2024; 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.