Active NPI
Julie Anna Gomez, LCSW
- Clinical Social Worker
- Cumming, GA
National Provider Identifier
1518577683
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- CSW007102
- Practice address
- 1200 Bald Ridge Marina Rd
Cumming, GA 30041-8526 - Phone
- (706) 216-2771
- NPI assigned
- Aug 4, 2020
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | CSW007102 | GA | Primary |
Addresses
Primary practice location
1200 Bald Ridge Marina Rd
Cumming, GA 30041-8526
Mailing address
2000 Professional Pkwy
# 200
Woodstock, GA 30188-4093
Phone (770) 517-8788
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
| License | State | Type | Specialty |
|---|---|---|---|
| CSW007102 | GA | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1596499200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1624233600000",
"number": "1518577683",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2000 PROFESSIONAL PKWY",
"address_2": "# 200",
"city": "WOODSTOCK",
"state": "GA",
"postal_code": "301884093",
"telephone_number": "770-517-8788",
"fax_number": "770-517-0250"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1200 BALD RIDGE MARINA RD",
"city": "CUMMING",
"state": "GA",
"postal_code": "300418526",
"telephone_number": "706-216-2771"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GOMEZ",
"first_name": "JULIE",
"middle_name": "ANNA",
"name_prefix": "Ms.",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-08-04",
"last_updated": "2021-06-21",
"certification_date": "2021-06-21",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "GA",
"license": "CSW007102",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Cumming, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.