Individual provider Active NPI

William P Gooley, LICSW

  • Clinical Social Worker
  • Auburn, MA
National Provider Identifier
1184649840
Registry record updated Jan 23, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
1024170 Issued in MA
Practice address
13 Arlington St
Auburn, MA 01501-2637
Phone
(508) 798-6699
Fax
(508) 798-7011
NPI assigned
Jul 13, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 23, 2012

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 1024170 MA Primary

Addresses

Primary practice location

13 Arlington St
Auburn, MA 01501-2637

Mailing address

696 Main St
Shrewsbury, MA 01545-3012
Phone (508) 845-7463

Other identifiers 2

IdentifierTypeStateIssuer
800012720OtherMARAIL ROAD MEDICARE
62-00270OtherMAEVERCARE

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
1024170MAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Eastpoint Services, LLC Clinical Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1152748800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1327276800000",
    "number": "1184649840",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "696 MAIN ST",
            "city": "SHREWSBURY",
            "state": "MA",
            "postal_code": "015453012",
            "telephone_number": "508-845-7463"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13 ARLINGTON ST",
            "city": "AUBURN",
            "state": "MA",
            "postal_code": "015012637",
            "telephone_number": "508-798-6699",
            "fax_number": "508-798-7011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOOLEY",
        "first_name": "WILLIAM",
        "middle_name": "P",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-13",
        "last_updated": "2012-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "1024170",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAIL ROAD MEDICARE",
            "identifier": "800012720",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EVERCARE",
            "identifier": "62-00270",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Auburn, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.