Individual provider Active NPI

Taylor M Gulley, LCSW

  • Clinical Social Worker
  • Gastonia, NC
National Provider Identifier
1316327752
Registry record updated Aug 16, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
C010902 Issued in NC
Practice address
1895 Hoffman Rd
Suite C
Gastonia, NC 28054-6557
Phone
(704) 865-3848
Fax
(704) 854-3086
NPI assigned
Jun 1, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 16, 2017

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X LCAS-20636 NC
Clinical Social Worker 1041C0700X P009655 NC
Clinical Social Worker 1041C0700X C010902 NC Primary

Addresses

Primary practice location

1895 Hoffman Rd
Suite C
Gastonia, NC 28054-6557

Mailing address

1867 Remount Rd
Suite H
Gastonia, NC 28054-7401
Phone (704) 865-3848

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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
I20170627001804 NC Practitioner - Clinical Social Worker 9739458282 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Caromont Medical Group IncGroup PAC ID 3577476258, 425 clinicians

Practice addresses (Care Compare)

1212 Spruce St
Suite 315
Belmont, NC 28012-3386
Phone (704) 865-3848

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LCAS-20636NCMDAddiction (Substance Use Disorder) Counselor
C010902NCMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Caromont Medical Group Inc CurrentSince Apr 16, 2017 Accepting new patients
Caromont Medical Group Inc Current Accepting new patients
Caromont Medical Group Inc CurrentSince Apr 16, 2017 Accepting new patients

Locations

1212 Spruce St
Ste 315
Belmont, NC 28012
Phone (704) 461-8253

1867 Remount Rd
Ste H
Gastonia, NC 28054
Phone (704) 671-7370

2240 Remount Rd
Gastonia, NC 28054
Phone (704) 671-5311

1895 Hoffman Rd
#A
Gastonia, NC 28054
Phone (704) 865-1749

1895 Hoffman Rd
Ste C
Gastonia, NC 28054

2525 Court Dr
Gastonia, NC 28054
Phone (704) 834-2662

Organizations & group practices 3

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": "1433116800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1502841600000",
    "number": "1316327752",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1867 REMOUNT RD",
            "address_2": "SUITE H",
            "city": "GASTONIA",
            "state": "NC",
            "postal_code": "280547401",
            "telephone_number": "704-865-3848",
            "fax_number": "704-854-3086"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1895 HOFFMAN RD",
            "address_2": "SUITE C",
            "city": "GASTONIA",
            "state": "NC",
            "postal_code": "280546557",
            "telephone_number": "704-865-3848",
            "fax_number": "704-854-3086"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GULLEY",
        "first_name": "TAYLOR",
        "middle_name": "M",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-06-01",
        "last_updated": "2017-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NC",
            "license": "LCAS-20636",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "P009655",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "C010902",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gastonia, NC

Sources for this page

Verify at the official NPI Registry.