Active NPI
Jennifer Goncalves, LCSW
- Clinical Social Worker
- Oklahoma City, OK
National Provider Identifier
1528524170
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 20399
- Practice address
- 921 NE 13TH St
Oklahoma City, OK 73104-5007 - Phone
- (405) 456-1000
- NPI assigned
- Feb 19, 2019
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | LCSW84749 | CA | |
| Clinical Social Worker | 1041C0700X | 20399 | OK | Primary |
Addresses
Primary practice location
921 NE 13TH St
Oklahoma City, OK 73104-5007
Mailing address
921 NE 13TH St
Oklahoma City, OK 73104-5007
Phone (405) 456-5546
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 |
|---|---|---|---|
| LCSW84749 | CA | MD | Clinical Social Worker |
| 20399 | OK | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1550534400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1715385600000",
"number": "1528524170",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "921 NE 13TH ST",
"city": "OKLAHOMA CITY",
"state": "OK",
"postal_code": "731045007",
"telephone_number": "405-456-5546"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "921 NE 13TH ST",
"city": "OKLAHOMA CITY",
"state": "OK",
"postal_code": "731045007",
"telephone_number": "405-456-1000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GONCALVES",
"first_name": "JENNIFER",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-02-19",
"last_updated": "2024-05-11",
"certification_date": "2024-05-11",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "CA",
"license": "LCSW84749",
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "OK",
"license": "20399",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Oklahoma City, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.