Mary Sloan Gorman, LCSW

Primary specialty

Social WorkerTaxonomy code 104100000X

License

005502 Issued in CT

Practice address

328 Howard St.
Apt a
Petaluma, CA 94952

Phone

(707) 789-7894

NPI assigned

Aug 30, 2006

Last updated

Sep 30, 2025By 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

Other identifiers 1

Other names 1

• Ms. Sloan Gorman Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Oct 1, 2025 through Oct 1, 2027

Medicare enrollment (NPD)

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.

• Relationship Center for Change a

  • Marriage & Family Therapist
  • Santa Rosa, CA
  • NPI 1689014615
  NPD (past)

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

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759190400000",
    "number": "1477663573",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "328 HOWARD ST.",
            "address_2": "APT A",
            "city": "PETALUMA",
            "state": "CA",
            "postal_code": "94952",
            "telephone_number": "707-789-7894"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "328 HOWARD ST.",
            "address_2": "APT A",
            "city": "PETALUMA",
            "state": "CA",
            "postal_code": "94952",
            "telephone_number": "707-789-7894"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2455 Bennett Valley Rd Ste C210",
            "address_purpose": "LOCATION",
            "city": "Santa Rosa",
            "state": "CA",
            "postal_code": "954045671",
            "country_code": "US",
            "telephone_number": "707-789-7894",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GORMAN",
        "first_name": "MARY",
        "middle_name": "SLOAN",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-30",
        "last_updated": "2025-09-30",
        "certification_date": "2025-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "CT",
            "license": "005502",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE OF CT LICENSE",
            "identifier": "005502",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SLOAN",
            "last_name": "GORMAN",
            "prefix": "MS.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Megan Nicole Goodspeed, RBT
• Jeremy LR Goodwin, MS, MD
• Lauren Gordon-Fahn, L.AC
• Barbara Lin Gordon
• Donovan Gordon
• Briauna Gortarez
• Christine Gosey
• David Gottlieb
• Jordan Austin Kai Gouveia, EMT
• Maureen Mona Grabowski, PH.D.

• Social Worker in Petaluma, CA
• Providers in Petaluma, CA by specialty
• Social Worker in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.