Nicole Yu-Lang Gostanian Moore

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

6517 Issued in CT

Practice address

317 N Main St
Manchester, CT 06042-2007

Phone

(860) 643-2101

NPI assigned

Nov 15, 2022

Last updated

Nov 15, 2022By the provider in NPPES

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

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in CT

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

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Jewish Family Services of Greater Hartford

  • Clinical Social Worker
  • West Hartford, CT
  • NPI 1891740221
  Medicare reassignment NPD
• Community Child Guidance Clinic, Inc.

  • Adolescent and Children Mental Health Clinic/Center
  • Manchester, CT
  • NPI 1780730267
  NPD (past)

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

{
    "created_epoch": "1668470400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1668470400000",
    "number": "1669181012",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "317 N MAIN ST",
            "city": "MANCHESTER",
            "state": "CT",
            "postal_code": "060422007",
            "telephone_number": "860-643-2101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "317 N MAIN ST",
            "city": "MANCHESTER",
            "state": "CT",
            "postal_code": "060422007",
            "telephone_number": "860-643-2101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "NICOLE",
        "middle_name": "YU-LANG GOSTANIAN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-11-15",
        "last_updated": "2022-11-15",
        "certification_date": "2022-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CT",
            "license": "6517",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "nicole.gostanian@uconn.edu",
            "affiliation": "N",
            "address_1": "22 Harmund Ct",
            "city": "Wethersfield",
            "state": "CT",
            "country_code": "US",
            "postal_code": "061091206",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Crystal Montanez
• Yomairis Montes
• Hannah J Moon
• Elizabeth L Moore, PHD
• Everlyn J Moore
• Saabreenah Moore, APRN
• Scott B. Moore, LMFT
• Valerie Moore
• Lohan Moradia, DDS
• Sabrina M Morais

• Clinical Social Worker in Manchester, CT
• Providers in Manchester, CT by specialty
• Clinical Social Worker in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2022; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.