Individual provider Active NPI

Carolina Gomez

  • Clinical Social Worker
  • Columbia, SC
National Provider Identifier
1326461310
Registry record updated Jan 27, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
10622 Issued in SC
Practice address
1332 Pickens St
Columbia, SC 29201-3430
Phone
(803) 771-4160
Fax
(803) 771-4367
NPI assigned
Jan 27, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 27, 2014

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 10622 SC Primary

Addresses

Primary practice location

1332 Pickens St
Columbia, SC 29201-3430

Mailing address

PO Box 3788
Columbia, SC 29230-3788
Phone (803) 733-5969

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

LicenseStateTypeSpecialty
10622SCMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1390780800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1390780800000",
    "number": "1326461310",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3788",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292303788",
            "telephone_number": "803-733-5969",
            "fax_number": "803-753-5591"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1332 PICKENS ST",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292013430",
            "telephone_number": "803-771-4160",
            "fax_number": "803-771-4367"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOMEZ",
        "first_name": "CAROLINA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-01-27",
        "last_updated": "2014-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "SC",
            "license": "10622",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2014; 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.