Individual provider Active NPI

Catherine Gore, LISW

  • Clinical Social Worker
  • Fairfield, OH
National Provider Identifier
1376568790
Registry record updated Dec 5, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
I.0003288 Issued in OH
Practice address
1251 Nilles Rd
Suite 5
Fairfield, OH 45014-7206
Phone
(513) 939-0300
Fax
(513) 939-0310
NPI assigned
Jul 13, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 5, 2017

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 I.0003288 OH Primary

Addresses

Primary practice location

1251 Nilles Rd
Suite 5
Fairfield, OH 45014-7206

Mailing address

1251 Nilles Rd
Suite 5
Fairfield, OH 45014-7206
Phone (513) 939-0300

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20060414000156 OH Practitioner - Clinical Social Worker 0446269674 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cincinnati Counseling Service, Inc.Group PAC ID 1658304910, 4 clinicians

Practice addresses (Care Compare)

5520 Harrison Ave
Cincinnati, OH 45248-2363
Phone (513) 922-1660

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
I.0003288OHMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Mindfully, LLC Clinical CurrentSince Oct 1, 2016 Accepting new patients
Cincinnati Counseling Service, Inc. Clinical CurrentSince Feb 7, 2020 Accepting new patients
Mindfully, LLC CurrentSince Oct 1, 2016 Accepting new patients
The Counseling Source, Inc. Past Accepting new patients
Psycho Social Therapies,LTD Clinical PastSince Dec 10, 2023 Accepting new patients
Family Service of the Cincinnati Area PastSince Mar 4, 2017 Accepting new patients
Psycho Social Therapies,LTD PastSince Dec 10, 2023 Accepting new patients

Locations

5520 Harrison Ave
Ste D
Cincinnati, OH 45248
Phone (513) 860-1100

8078 Beechmont Ave
Unit E
Cincinnati, OH 45255
Phone (513) 934-0300

1251 Nilles Rd
Ste 5
Fairfield, OH 45014
Phone (732) 993-4599

Organizations & group practices 7

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": "1152748800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1512432000000",
    "number": "1376568790",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1251 NILLES RD",
            "address_2": "SUITE 5",
            "city": "FAIRFIELD",
            "state": "OH",
            "postal_code": "450147206",
            "telephone_number": "513-939-0300",
            "fax_number": "513-939-0310"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1251 NILLES RD",
            "address_2": "SUITE 5",
            "city": "FAIRFIELD",
            "state": "OH",
            "postal_code": "450147206",
            "telephone_number": "513-939-0300",
            "fax_number": "513-939-0310"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GORE",
        "first_name": "CATHERINE",
        "credential": "LISW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-13",
        "last_updated": "2017-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "I.0003288",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairfield, OH

Sources for this page

Verify at the official NPI Registry.