Angela Rene Gaston, LCSW

Individual provider Active NPI Clinical Social Worker · Joplin, MO

NPI 1225206451 · NPPES record last updated Feb 8, 2010

Key facts

NPI
1225206451
Entity type
Individual (NPI type 1)
Primary specialty
Clinical Social Worker 1041C0700X
License
2007028756 (MO)
Practice address
1230 N Duquesne Rd
Joplin, MO 64801-1509
Phone
(417) 782-1443
Fax
(417) 782-3240
NPI assigned
Feb 11, 2008
Sex
Female
Sole proprietor
No

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 and National Provider Directory roles.

Medicare Care Compare profile

Specialty
Clinical Social Worker
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
College Skyline Center LLC (17 clinicians)

Practice addresses (Care Compare)

1230 N Duquesne Rd
Joplin, MO 64801-1509
Phone (417) 782-1443

Medicare participation

Medicare fee-for-service enrollment
Enrolled in MO
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20080320000147 MO Practitioner - Clinical Social Worker 2062598733 Reassigns benefits to 1 organization

National Provider Directory

Medicare enrollment (NPD)
Yes

Practice roles

OrganizationSpecialtyStatusNew patients
College Skyline Center LLC Current
since Feb 1, 2010
Accepting new patients

Locations

1230 N Duquesne Rd
Joplin, MO 64801
Phone (417) 782-1443

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 2007028756 MO Yes

Addresses

Primary practice location

1230 N Duquesne Rd
Joplin, MO 64801-1509

Mailing address

1230 N Duquesne Rd
Joplin, MO 64801-1509
Phone (417) 782-1443

Other providers in Joplin, MO

All providers in Joplin, MO · Clinical Social Worker in Missouri

Sources for this page

Verify at the official NPI Registry.