Gabrielle Gough, LCSW

Primary specialty

Social WorkerTaxonomy code 104100000X

License

SW22223 Issued in FL

Practice address

4858 Parete Cir
Jacksonville, FL 32218-1255

Phone

(860) 759-4828

NPI assigned

Jun 10, 2016

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in FL

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, 2020

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

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 and National Provider Directory roles.

• Uplift Behavioral Health PC

  • Adult Mental Health Clinic/Center
  • Bethesda, MD
  • NPI 1629740410

  FL

  Medicare reassignment
• Mental Health Association, Inc.

  • Community/Behavioral Health Agency
  • Springfield, MA
  • NPI 1285104141
  NPD (past)

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

{
    "created_epoch": "1465516800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732492800000",
    "number": "1508215427",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4858 PARETE CIR",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322181255",
            "telephone_number": "860-759-4828"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4858 PARETE CIR",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322181255",
            "telephone_number": "860-759-4828"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOUGH",
        "first_name": "GABRIELLE",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-06-10",
        "last_updated": "2024-11-25",
        "certification_date": "2024-11-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "FL",
            "license": "SW22223",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "046197938",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tiffany Paige Goth
• Madison Leigh Gotro, RBT
• Christine Gottschalk
• Tajvar H Goudarzi, MD
• Christopher Gough, DDS
• Alexandra Victoria Goulbourne
• Hannah Gould, MD
• Mark T Gould, MD
• Twanna M Gould, LD/N
• Waldemar Melvin Goulet Jr., FNP-BC, NP-C

• Social Worker in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Social Worker in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 25, 2024; 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.