Individual provider Active NPI

E Vaughan Gilmore, LCSW LCDC

  • Clinical Social Worker
  • Houston, TX
National Provider Identifier
1366801615
Registry record updated Feb 15, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
51165 Issued in TX
Practice address
12301 Main St
Houston, TX 77035-6207
Phone
(713) 275-5310
NPI assigned
Feb 15, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 15, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 12668 TX
Clinical Social Worker 1041C0700X 51165 TX Primary

Addresses

Primary practice location

12301 Main St
Houston, TX 77035-6207

Mailing address

12301 Main St
Houston, TX 77035-6207
Phone (713) 275-5310

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
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.
Opted out of Medicare
Yes, effective Apr 1, 2016 through Apr 1, 2028

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
51165TXMDClinical Social Worker
12668TXMDDental Hygienist

NPI Registry JSON

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

{
    "created_epoch": "1455494400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1455494400000",
    "number": "1366801615",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12301 MAIN ST",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770356207",
            "telephone_number": "713-275-5310"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12301 MAIN ST",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770356207",
            "telephone_number": "713-275-5310"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GILMORE",
        "first_name": "E VAUGHAN",
        "credential": "LCSW LCDC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-02-15",
        "last_updated": "2016-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "TX",
            "license": "12668",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TX",
            "license": "51165",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

Verify at the official NPI Registry.