Individual provider Active NPI

Coleman Blair Gockley, LMSW

  • School Social Worker
  • Rochester, NY
National Provider Identifier
1437668167
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
School Social WorkerTaxonomy code 1041S0200X
License
091903-1 Issued in NY
Practice address
190 Reynolds St
Clara Barton School No.2, RCSD
Rochester, NY 14608
Phone
(585) 235-2820
Fax
(585) 464-6174
NPI assigned
Sep 26, 2017
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
School Social Worker 1041S0200X 091903-1 NY Primary

Addresses

Primary practice location

190 Reynolds St
Clara Barton School No.2, RCSD
Rochester, NY 14608

Mailing address

190 Reynolds St
Rochester, NY 14608-2540
Phone (585) 235-2820

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
091903-1NYMDSchool Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1506384000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1437668167",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "190 REYNOLDS ST",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146082540",
            "telephone_number": "585-235-2820",
            "fax_number": "585-464-6174"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "190 REYNOLDS ST",
            "address_2": "CLARA BARTON SCHOOL NO.2, RCSD",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "14608",
            "telephone_number": "585-235-2820",
            "fax_number": "585-464-6174"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOCKLEY",
        "first_name": "COLEMAN",
        "middle_name": "BLAIR",
        "name_prefix": "Mr.",
        "credential": "LMSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-09-26",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041S0200X",
            "taxonomy_group": "",
            "desc": "Social Worker, School",
            "state": "NY",
            "license": "091903-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rochester, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.