Individual provider Active NPI

Joseph Martin Goryl, MA, LPC, LMSW

  • Clinical Social Worker
  • Sandusky, MI
National Provider Identifier
1427239086
Registry record updated Nov 23, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6801016434 Issued in MI
Practice address
119 E Sanilac Rd
Suite #3
Sandusky, MI 48471-1184
Phone
(810) 648-4303
Fax
(810) 648-2988
NPI assigned
Nov 23, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 23, 2007

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 6401004005 MI
Clinical Social Worker 1041C0700X 6801016434 MI Primary

Addresses

Primary practice location

119 E Sanilac Rd
Suite #3
Sandusky, MI 48471-1184

Mailing address

119 E Sanilac Rd
Suite #3
Sandusky, MI 48471-1184
Phone (810) 648-4303

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20080719000035 MI Practitioner - Clinical Social Worker 1850464132 Practice locations: Sandusky, MI

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1977
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

119 E Sanilac Rd
Suite 3
Sandusky, MI 48471-1184
Phone (810) 648-4303

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
6401004005MIMDProfessional Counselor

NPI Registry JSON

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

{
    "created_epoch": "1195776000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1195776000000",
    "number": "1427239086",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "119 E SANILAC RD",
            "address_2": "SUITE #3",
            "city": "SANDUSKY",
            "state": "MI",
            "postal_code": "484711184",
            "telephone_number": "810-648-4303",
            "fax_number": "810-648-2988"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "119 E SANILAC RD",
            "address_2": "SUITE #3",
            "city": "SANDUSKY",
            "state": "MI",
            "postal_code": "484711184",
            "telephone_number": "810-648-4303",
            "fax_number": "810-648-2988"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GORYL",
        "first_name": "JOSEPH",
        "middle_name": "MARTIN",
        "name_prefix": "Mr.",
        "credential": "MA, LPC, LMSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-11-23",
        "last_updated": "2007-11-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MI",
            "license": "6401004005",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801016434",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sandusky, MI

Sources for this page

Verify at the official NPI Registry.