Sophie Gonsoulin, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

68094 Issued in TX

Practice address

3140 N Hall St Apt 320
Dallas, TX 75204-1287

Phone

(409) 789-3394

NPI assigned

Mar 15, 2023

Last updated

Apr 11, 2023By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Soul Studio Clinical Services PLLC

  • Clinical Social Worker
  • Dallas, TX
  • NPI 1952261398
  NPD Authorized official

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

{
    "created_epoch": "1678838400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681171200000",
    "number": "1417658485",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3140 N HALL ST APT 320",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752041287",
            "telephone_number": "409-789-3394"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3140 N HALL ST APT 320",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752041287",
            "telephone_number": "409-789-3394"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GONSOULIN",
        "first_name": "SOPHIE",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-03-15",
        "last_updated": "2023-04-11",
        "certification_date": "2023-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TX",
            "license": "68094",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Victor M Gomez, M.D.
• Keerthi Gondi
• Mei Gong
• Timothy Allan Gong, M.D.
• Wei Gong, M.D.
• John Andrew Gonzaba
• Gonzalaz Med Supplies LLC
• Alana Jade Gonzales, PHARMD
• Angie T Gonzales, CPO
• Antonio Gonzales, LPC

• Clinical Social Worker in Dallas, TX
• Providers in Dallas, TX by specialty
• Clinical Social Worker in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2023; 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.