Monique L Gore, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

7158-123 Issued in WI

Practice address

3158 Eaton Rd
Green Bay, WI 54311-6827

Phone

(920) 770-3319

Fax

(920) 600-0271

NPI assigned

Oct 27, 2005

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 2

Medicare fee-for-service enrollment

Enrolled in WI

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, 1995

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Solution Focused Counseling LLC

  • Clinical Social Worker
  • Green Bay, WI
  • NPI 1104698760
  Medicare reassignment NPD Authorized official
• Oneida Nation

  • Clinic/Center
  • Oneida, WI
  • NPI 1740278308
  Medicare reassignment NPD
• Phoenix Behavioral Health Services, LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Two Rivers, WI
  • NPI 1871514778
  Medicare reassignment NPD

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

{
    "created_epoch": "1130371200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699660800000",
    "number": "1568452803",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3158 EATON RD",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543116827",
            "telephone_number": "920-819-3970",
            "fax_number": "920-600-0271"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3158 EATON RD",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543116827",
            "telephone_number": "920-770-3319",
            "fax_number": "920-600-0271"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3120 Memorial Dr",
            "address_purpose": "LOCATION",
            "city": "Two Rivers",
            "state": "WI",
            "postal_code": "542413229",
            "country_code": "US",
            "telephone_number": "920-657-1465",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GORE",
        "first_name": "MONIQUE",
        "middle_name": "L",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-10-27",
        "last_updated": "2023-11-11",
        "certification_date": "2023-11-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WI",
            "license": "7158-123",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "43562500",
            "state": "WI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mgore@phoenixbhc.com",
            "affiliation": "N",
            "endpointDescription": "mgore@phoenixbhc.com",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "3120 Memorial Dr",
            "city": "Two Rivers",
            "state": "WI",
            "country_code": "US",
            "postal_code": "542413229",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mgore@sfc-wi.com",
            "affiliation": "N",
            "endpointDescription": "Professional Email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "3158 Eaton Rd",
            "city": "Green Bay",
            "state": "WI",
            "country_code": "US",
            "postal_code": "543116827",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Deborah Ann Goodine, LPC-IT
• Jessica Goodrich, LPC
• Philip L Goolsby, MD
• Lakshmi Gopalakrishnan Nair, MD
• Tanya M Gorder, OD
• Brooke E Gorzek, NP
• Joann Mary Gosz, APNP
• Sarah Gottfredsen, PA-C
• Lawrence Adam Gottlieb
• Todd Gould, MD

• Clinical Social Worker in Green Bay, WI
• Providers in Green Bay, WI by specialty
• Clinical Social Worker in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 11, 2023; 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.