Active NPI
Lawrence Lorenzo Goncalves Jr., LICSW
- Clinical Social Worker
- Tacoma, WA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- LW00009741
- Practice address
- 4301 S Pine St Ste 301
Tacoma, WA 98409-7206 - Phone
- (253) 476-6500
- NPI assigned
- Feb 22, 2007
- Last updated
- May 5, 2021
- Sex
- Male
- Sole proprietor
- No
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 | LW00009741 | WA | Primary |
Addresses
Primary practice location
4301 S Pine St Ste 301
Tacoma, WA 98409-7206
Mailing address
4301 S Pine St Ste 301
Tacoma, WA 98409-7206
Phone (253) 476-6500
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| LW00009741 | Other | WA | LICSW |
| RC00029532 | Other | WA | REGISTERED COUNSELOR |
Other names 1
- Larry Goncalves
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| SOAP URL | https://careepicwa.kp.org:14430/Interconnect-CE-PRD/wcf/epic.community.hie/xcpdrespondinggatewaysync | Health Information Exchange (HIE) |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Social Worker
- Education
- Other, 2001
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
275 Bronson Way NE
Renton, WA 98056-4030
Phone (425) 235-2800
9505 S Steele St
Tacoma, WA 98444-1858
Phone (253) 597-6800
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LW00009741 | WA | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Kaiser Foundation Health Plan of Washington | Current | Accepting new patients | |
| Kaiser Foundation Health Plan of Washington | Current | Accepting new patients | |
| Kaiser Foundation Health Plan of Washington | Current | Accepting new patients |
Locations
200 15th Ave E
Seattle, WA 98112
Phone (206) 326-4530
4301 S Pine St
Ste 301
Tacoma, WA 98409
Phone (253) 476-6500
9505 S Steele St
Tacoma, WA 98444
Phone (253) 597-6800
Organizations & group practices 3
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.
-
- Multi-Specialty Clinic/Center
- Seattle, WA
- NPI 1396810701
-
- Multi-Specialty Clinic/Center
- Renton, WA
- NPI 1124264577
-
dba Everett Medical Center
- Multi-Specialty Clinic/Center
- Everett, WA
- NPI 1386935351
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1172102400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1620172800000",
"number": "1427183409",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4301 S PINE ST STE 301",
"city": "TACOMA",
"state": "WA",
"postal_code": "984097206",
"telephone_number": "253-476-6500"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4301 S PINE ST STE 301",
"city": "TACOMA",
"state": "WA",
"postal_code": "984097206",
"telephone_number": "253-476-6500"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GONCALVES",
"first_name": "LAWRENCE",
"middle_name": "LORENZO",
"name_prefix": "Mr.",
"name_suffix": "Jr.",
"credential": "LICSW",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-02-22",
"last_updated": "2021-05-05",
"certification_date": "2021-05-05",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "WA",
"license": "LW00009741",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LICSW",
"identifier": "LW00009741",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "REGISTERED COUNSELOR",
"identifier": "RC00029532",
"state": "WA"
}
],
"endpoints": [
{
"endpointType": "SOAP",
"endpointTypeDescription": "SOAP URL",
"endpoint": "https://careepicwa.kp.org:14430/Interconnect-CE-PRD/wcf/epic.community.hie/xcpdrespondinggatewaysync",
"affiliation": "N",
"endpointDescription": "Carequality",
"use": "HIE",
"useDescription": "Health Information Exchange (HIE)",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "C-CDA",
"address_1": "4301 S Pine St Ste 301",
"city": "Tacoma",
"state": "WA",
"country_code": "US",
"postal_code": "984097206",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": [
{
"first_name": "LARRY",
"last_name": "GONCALVES",
"code": "5",
"type": "Other Name"
}
]
}
Other providers in Tacoma, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2021; 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.