Verg Life LLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

VERG LIFE LLC

Practice address

11060 E Division Rd
Knox, IN 46534-8733

Phone

(219) 707-8523

Fax

(219) 707-8523

NPI assigned

Apr 24, 2023

Organization subpart

No

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

Authorized official

Name

Amye Renee Gourley, LCSWNPI 1558006924

Title

Owner/Clinical Social Worker

Phone

(219) 707-8523

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IN

Enrollment records 1

Locations

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Amye Renee Gourley, LCSW

  • Clinical Social Worker
  • Knox, IN
  • NPI 1558006924
  Medicare reassignment NPD Authorized official
• Sherrie Ann Shivok, LMHC

  • Mental Health Counselor
  • Valparaiso, IN
  • NPI 1851865281
  NPD
• Theresa M Alexander, MD

  • Family Medicine Physician
  • Knox, IN
  • NPI 1467438994
  NPD (past)
• Karen Sue Koch, DO

  • Family Medicine Physician
  • Helena, MT
  • NPI 1457359549
  NPD (past)

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

{
    "created_epoch": "1682294400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1731801600000",
    "number": "1598452070",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11060 E DIVISION RD",
            "city": "KNOX",
            "state": "IN",
            "postal_code": "465348733",
            "telephone_number": "219-707-8523",
            "fax_number": "219-707-8523"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11060 E DIVISION RD",
            "city": "KNOX",
            "state": "IN",
            "postal_code": "465348733",
            "telephone_number": "219-707-8523",
            "fax_number": "219-707-8523"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10924 Lincoln Hwy",
            "address_purpose": "LOCATION",
            "city": "Plymouth",
            "state": "IN",
            "postal_code": "465638680",
            "country_code": "US",
            "telephone_number": "219-707-8523",
            "fax_number": "219-707-8523",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1006 S Edgewood Dr",
            "address_purpose": "LOCATION",
            "city": "Knox",
            "state": "IN",
            "postal_code": "465348226",
            "country_code": "US",
            "telephone_number": "219-707-8523",
            "fax_number": "219-707-8523",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "VERG LIFE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-04-24",
        "last_updated": "2024-11-17",
        "certification_date": "2024-11-17",
        "status": "A",
        "authorized_official_last_name": "GOURLEY",
        "authorized_official_first_name": "AMYE",
        "authorized_official_middle_name": "RENEE",
        "authorized_official_title_or_position": "OWNER/CLINICAL SOCIAL WORKER",
        "authorized_official_telephone_number": "219-707-8523",
        "authorized_official_credential": "LCSW"
    },
    "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 Knox, IN
• Providers in Knox, IN by specialty
• Clinical Social Worker in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.