Gary W Gossage Licensed Clinical Social Work

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

GARY W GOSSAGE LICENSED CLINICAL SOCIAL WORK

Practice address

1910 Payton Cir
Colorado Springs, CO 80915-1327

Phone

(701) 400-2592

Fax

(719) 631-0577

NPI assigned

Feb 27, 2020

Organization subpart

No

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

Authorized official

Name

Gary W Gossage

Title

Owner

Phone

(701) 400-2592

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1582761600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1583193600000",
    "number": "1487288510",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1910 PAYTON CIR",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809151327",
            "telephone_number": "701-400-2592",
            "fax_number": "719-631-0577"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1910 PAYTON CIR",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809151327",
            "telephone_number": "701-400-2592",
            "fax_number": "719-631-0577"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GARY W GOSSAGE LICENSED CLINICAL SOCIAL WORK",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-02-27",
        "last_updated": "2020-03-03",
        "certification_date": "2020-03-03",
        "status": "A",
        "authorized_official_last_name": "GOSSAGE",
        "authorized_official_first_name": "GARY",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "701-400-2592"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Social Worker in Colorado Springs, CO
• Providers in Colorado Springs, CO by specialty
• Clinical Social Worker in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2020; 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.