Angela Gouge, LCSW
Individual provider Active NPI Clinical Social Worker · Connelly Springs, NC
NPI 1184226508 · NPPES record last updated Nov 10, 2020
Key facts
- NPI
- 1184226508
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Social Worker 1041C0700X
- License
- C012856 (NC)
- Practice address
- 5072 Dora LN
Connelly Springs, NC 28612-7509 - Phone
- (828) 850-5901
- NPI assigned
- Nov 10, 2020
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| C012856 | NC | MD | Clinical Social Worker |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | C012856 | NC | Yes |
Addresses
Primary practice location
5072 Dora LN
Connelly Springs, NC 28612-7509
Mailing address
5072 Dora LN
Connelly Springs, NC 28612-7509
Phone (828) 850-5901
Other providers in Connelly Springs, NC
- Joseph Eric Franklin
- Nicole Lauren Gaines
- Gaston Family Health Services, Inc
- Gaston Family Health Services, Inc
- Jackson Genant
- Quincy Justin Greene
- Shawn M Hamm
- Landon John Hamren
- Amber Michelle Harding
- Mary Hawkins
All providers in Connelly Springs, NC · Clinical Social Worker in North Carolina
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 10, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.