Active NPI
Katherine S Gong, LCSW, DCSW
- Clinical Social Worker
- Key Largo, FL
National Provider Identifier
1376631135
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- SW 5450
- Practice address
- 103400 Overseas Hwy
Suite 201/202
Key Largo, FL 33037-2834 - Phone
- (305) 394-4006
- Fax
- (305) 451-2816
- NPI assigned
- Oct 10, 2006
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | SW 5450 | FL | Primary |
Addresses
Primary practice location
103400 Overseas Hwy
Suite 201/202
Key Largo, FL 33037-2834
Mailing address
PO Box 371836
Key Largo, FL 33037-1836
Phone (305) 394-4006
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| Z062E | Other | FL | BLUE CROSS BLUE SHIELD |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in FL
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20070619000690 | FL | Practitioner - Clinical Social Worker | 4688773476 | Practice locations: Key Largo, FL |
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Social Worker
- Education
- Other, 1977
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
Practice addresses (Care Compare)
103400 Overseas Hwy 213
Key Largo, FL 33037-2848
Phone (305) 451-3044
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| SW 5450 | FL | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1160438400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1242864000000",
"number": "1376631135",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 371836",
"city": "KEY LARGO",
"state": "FL",
"postal_code": "330371836",
"telephone_number": "305-394-4006",
"fax_number": "305-451-2816"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "103400 OVERSEAS HWY",
"address_2": "SUITE 201/202",
"city": "KEY LARGO",
"state": "FL",
"postal_code": "330372834",
"telephone_number": "305-394-4006",
"fax_number": "305-451-2816"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GONG",
"first_name": "KATHERINE",
"middle_name": "S",
"credential": "LCSW, DCSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-10-10",
"last_updated": "2009-05-21",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "FL",
"license": "SW 5450",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "Z062E",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Key Largo, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.