NPIMap

Organization Active NPI

Thomas a Gonsalves Incorporated

  • Clinical Social Worker
  • McComb, MS
National Provider Identifier
1659311967
Registry record updated Oct 19, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
C5647 Issued in MS
Legal business name
THOMAS A GONSALVES INCORPORATED
Practice address
307 Apache Drive
Suite B
McComb, MS 39648-6309
Phone
(601) 551-1327
NPI assigned
Jun 7, 2006
Last updated
Oct 19, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 19, 2010

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

Authorized official

Name
Mr. Thomas Allen Gonsalves, AM LCSWNPI 1518173525
Title
President of Corporation Private
Phone
(601) 551-1327

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X C5647 MS Primary

Addresses

Primary practice location

307 Apache Drive
Suite B
McComb, MS 39648-6309

Mailing address

307 Apache Drive
Suite B
McComb, MS 39648-6309
Phone (601) 551-1327

Other identifiers 2

IdentifierTypeStateIssuer
279761404AOtherMSBLUE CROSS BLUE SHIELD
01908563MedicaidMS

National Provider Directory

National Provider Directory

Locations

307 Apache Dr
#B
McComb, MS 39648
Phone (601) 551-1327

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1149638400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1287446400000",
    "number": "1659311967",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "307 APACHE DRIVE",
            "address_2": "SUITE B",
            "city": "MCCOMB",
            "state": "MS",
            "postal_code": "396486309",
            "telephone_number": "601-551-1327"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "307 APACHE DRIVE",
            "address_2": "SUITE B",
            "city": "MCCOMB",
            "state": "MS",
            "postal_code": "396486309",
            "telephone_number": "601-551-1327"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THOMAS A GONSALVES INCORPORATED",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-07",
        "last_updated": "2010-10-19",
        "status": "A",
        "authorized_official_last_name": "GONSALVES",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "ALLEN",
        "authorized_official_title_or_position": "PRESIDENT OF CORPORATION PRIVATE",
        "authorized_official_telephone_number": "601-551-1327",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "AM LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MS",
            "license": "C5647",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "279761404A",
            "state": "MS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01908563",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in McComb, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.