Jacqueline Elizabeth Gomez, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

L7655 Issued in OR

Practice address

1918 NE 143Rd Ave
Portland, OR 97230-4101

Phone

(503) 726-9630

NPI assigned

Jun 27, 2013

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Interoperability endpoints

• FHIR API: https://api.qualifacts.org/api/fhir/family-solutions/r4/

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.

• Cascade Therapy Center, LLC

  • Adult Mental Health Clinic/Center
  • Portland, OR
  • NPI 1033740204
  NPD Authorized official
• Family Solutions, Inc

  • Community/Behavioral Health Agency
  • Vancouver, WA
  • NPI 1831258995
  NPD (past)

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

{
    "created_epoch": "1372291200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1580083200000",
    "number": "1669812210",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1918 NE 143RD AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972304101",
            "telephone_number": "503-726-9630"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1918 NE 143RD AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972304101",
            "telephone_number": "503-726-9630"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOMEZ",
        "first_name": "JACQUELINE",
        "middle_name": "ELIZABETH",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-06-27",
        "last_updated": "2020-01-27",
        "certification_date": "2020-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WA",
            "license": "LW60770104",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OR",
            "license": "L7655",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Arianna Gomez
• Brenda Gomez
• Brian Jacob Gomez, IDC, USN
• Elizabeth Nuria Gomez, LMFT
• Flor Gomez
• John Lyle Tron Montero Gomez, M.D.
• Miguel Gomez I
• Silvia Gomez
• Tehniyah N Gomez, PNP-PC
• Teresa Gomez

• Clinical Social Worker in Portland, OR
• Providers in Portland, OR by specialty
• Clinical Social Worker in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2020; 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.