Active NPI
Kathy Goss
- Social Worker
- Addison, IL
National Provider Identifier
1649073669
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 116339
- Practice address
- 211 E Lake St
Addison, IL 60101-2886 - Phone
- (312) 600-5057
- NPI assigned
- Mar 27, 2025
- 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 | ISW21643 | FL | |
| Social Worker | 104100000X | 116339 | IL | Primary |
Addresses
Primary practice location
211 E Lake St
Addison, IL 60101-2886
Mailing address
1114 Democracy Dr
Haines City, FL 33844-6431
Phone (407) 457-7297
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 |
|---|---|---|---|
| 116339 | IL | MD | Social Worker |
| ISW21643 | FL | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Asante Counseling | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Chicago, IL
- NPI 1184474231
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1743033600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1743033600000",
"number": "1649073669",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1114 DEMOCRACY DR",
"city": "HAINES CITY",
"state": "FL",
"postal_code": "338446431",
"telephone_number": "407-457-7297"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "211 E LAKE ST",
"city": "ADDISON",
"state": "IL",
"postal_code": "601012886",
"telephone_number": "312-600-5057"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GOSS",
"first_name": "KATHY",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2025-03-27",
"last_updated": "2025-03-27",
"certification_date": "2025-03-27",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "FL",
"license": "ISW21643",
"primary": false
},
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "IL",
"license": "116339",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Addison, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.