Individual provider Active NPI

Eileen McDermott Ganong, LCSW

  • Clinical Social Worker
  • West Palm Beach, FL
National Provider Identifier
1285084541
Registry record updated Jun 17, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
SW11716 Issued in FL
Practice address
1041 45TH St
West Palm Beach, FL 33407-2402
Phone
(561) 383-5923
Fax
(561) 512-1280
NPI assigned
Jun 17, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 17, 2016

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 SW11716 FL Primary

Addresses

Primary practice location

1041 45TH St
West Palm Beach, FL 33407-2402

Mailing address

1041 45TH St
West Palm Beach, FL 33407-2402
Phone (561) 383-5923

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200204000943 ID Practitioner - Clinical Social Worker 7315373750 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Thrive Counseling LLCGroup PAC ID 0749458420, 1,187 clinicians

Practice addresses (Care Compare)

26 S Baltic PL
Suite 150
Meridian, ID 83642-5508
Phone (855) 284-7483

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
SW11716FLMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Thrive Counseling LLC CurrentSince Feb 15, 2022 Accepting new patients

Locations

26 S Baltic Pl
Ste 150
Meridian, ID 83642

136 N Broadmore Way
Ste 103
Nampa, ID 83687
Phone (571) 554-1147

1000 Jefferson St
Ste 2C
Lynchburg, VA 24504
Phone (434) 528-3263

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.

NPI Registry JSON

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

{
    "created_epoch": "1466121600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1466121600000",
    "number": "1285084541",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1041 45TH ST",
            "city": "WEST PALM BEACH",
            "state": "FL",
            "postal_code": "334072402",
            "telephone_number": "561-383-5923",
            "fax_number": "561-512-1280"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1041 45TH ST",
            "city": "WEST PALM BEACH",
            "state": "FL",
            "postal_code": "334072402",
            "telephone_number": "561-383-5923",
            "fax_number": "561-512-1280"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCDERMOTT GANONG",
        "first_name": "EILEEN",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-06-17",
        "last_updated": "2016-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW11716",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Palm Beach, FL

Sources for this page

Verify at the official NPI Registry.