Mary Kelly Gomeringer, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

C007914 Issued in NC

Practice address

401 E Lakewood Ave
Ste E
Durham, NC 27707-1700

Phone

(919) 286-2146

Fax

(919) 908-6787

NPI assigned

Jun 23, 2011

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Jul 1, 2024 through Jul 1, 2028

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.

• Obsidian Care Collective PLLC

  • Clinical Social Worker
  • Hillsborough, NC
  • NPI 1336804095
  NPD
• Visions Counseling Studio

  • Mental Health Counselor
  • Durham, NC
  • NPI 1124274626
  NPD (past)

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

{
    "created_epoch": "1308787200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1386028800000",
    "number": "1619263167",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 E LAKEWOOD AVE",
            "address_2": "STE E",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277071700",
            "telephone_number": "919-286-2146",
            "fax_number": "919-908-6787"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 E LAKEWOOD AVE",
            "address_2": "STE E",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277071700",
            "telephone_number": "919-286-2146",
            "fax_number": "919-908-6787"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOMERINGER",
        "first_name": "MARY",
        "middle_name": "KELLY",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-06-23",
        "last_updated": "2013-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "C007914",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Yvonne M Golightly, P.T.
• Vishnukamal Golla
• Seanna G Golladay
• Jared Gollob
• Franchesca Sheree Golson, LCSWA
• Cindrella Gomes
• Ian Paul Giovanni Gomez
• Miraida Gomez, LCSWA
• Michael Joseph Goncalves, MD
• Jabez Gondokusumo, MD

• Clinical Social Worker in Durham, NC
• Providers in Durham, NC by specialty
• Clinical Social Worker in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.