Dennis R. Gourley, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

CW013873 Issued in PA

Practice address

480 Pierce Street
Suite 112
Kingston, PA 18704-5512

Phone

(570) 714-0890

Fax

(570) 714-0890

NPI assigned

Oct 5, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in PA

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

Specialty

Clinical Social Worker

Education

Other, 1995

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Professional Development Services IncGroup PAC ID 5395631469, 5 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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.

• Professional Development Services Inc

  • Social Worker
  • Hanover Township, PA
  • NPI 1104886548
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1160006400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1429142400000",
    "number": "1447346234",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "480 PIERCE STREET",
            "address_2": "SUITE 112",
            "city": "KINGSTON",
            "state": "PA",
            "postal_code": "187045512",
            "telephone_number": "570-714-0890",
            "fax_number": "570-714-0890"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "480 PIERCE STREET",
            "address_2": "SUITE 112",
            "city": "KINGSTON",
            "state": "PA",
            "postal_code": "187045512",
            "telephone_number": "570-714-0890",
            "fax_number": "570-714-0890"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOURLEY",
        "first_name": "DENNIS",
        "middle_name": "R.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-05",
        "last_updated": "2015-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "PA",
            "license": "CW013873",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "101659198",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Christina Gelso
• George C Tsoutsoplides MD
• John Giampietro, PT, DPT
• Anthony Giardina, DO
• Gordon Wellness Center LLC
• Mary Lou Gray, OTR/L
• Ellen Greenberg, M.A.
• Carol Esther Greenwald, M.S., NCC
• David W Greenwald, MD
• Tammy Gregorowicz, PHD

• Clinical Social Worker in Kingston, PA
• Providers in Kingston, PA by specialty
• Clinical Social Worker in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2015; 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.

Verify at the official NPI Registry.