Active NPI
Angela Gouge, LCSW
- Clinical Social Worker
- Connelly Springs, NC
National Provider Identifier
1184226508
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- C012856
- Practice address
- 5072 Dora LN
Connelly Springs, NC 28612-7509 - Phone
- (828) 850-5901
- NPI assigned
- Nov 10, 2020
- Last updated
- Nov 10, 2020
- Sex
- Female
- 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 | C012856 | NC | Primary |
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
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 |
|---|---|---|---|
| C012856 | NC | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1604966400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1604966400000",
"number": "1184226508",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5072 DORA LN",
"city": "CONNELLY SPRINGS",
"state": "NC",
"postal_code": "286127509",
"telephone_number": "828-850-5901"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5072 DORA LN",
"city": "CONNELLY SPRINGS",
"state": "NC",
"postal_code": "286127509",
"telephone_number": "828-850-5901"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GOUGE",
"first_name": "ANGELA",
"credential": "LCSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-11-10",
"last_updated": "2020-11-10",
"certification_date": "2020-11-10",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "NC",
"license": "C012856",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Connelly Springs, NC
- Joseph Eric Franklin, FNP-C
- Nicole Lauren Gaines, LPC
- Gaston Family Health Services, Inc (Kintegra at East Burke High)
- Gaston Family Health Services, Inc (Kintegra at East Burke Middle)
- Jackson Genant, M.D.
- Angela McKinney Gragg, LCSWA
- Quincy Justin Greene, M.D.
- Tia Londia Guillen, FNP
- Shawn M Hamm, DO
- Landon John Hamren, DMD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 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.