Individual provider Active NPI

Gayle Gonzalez-Johnson, MSW, LCSW, ACSW

  • Clinical Social Worker
  • Cary, NC
National Provider Identifier
1700895620
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
001027 Issued in NC
Practice address
531 Keisler Dr
Suite 203
Cary, NC 27511-9307
Phone
(919) 816-0009
Fax
(919) 828-9702
NPI assigned
Aug 7, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 001027 NC Primary

Addresses

Primary practice location

531 Keisler Dr
Suite 203
Cary, NC 27511-9307

Mailing address

531 Keisler Dr
Suite 203
Cary, NC 27511-9307
Phone (919) 816-0009

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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

Enrollment IDStateProvider typePAC IDDetails
I20061208000467 NC Practitioner - Clinical Social Worker 3375542996 Practice locations: Cary, NC

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
University of North Carolina at Chapel Hill School of Medicine, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

531 Keisler Dr
Suite 203
Cary, NC 27518-9307

531 Keisler Drive
203 West Wake Office Center
Cary, NC 27518-9307
Phone (919) 816-0009

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
001027NCMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1154908800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1700895620",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "531 KEISLER DR",
            "address_2": "SUITE 203",
            "city": "CARY",
            "state": "NC",
            "postal_code": "275119307",
            "telephone_number": "919-816-0009",
            "fax_number": "919-828-9702"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "531 KEISLER DR",
            "address_2": "SUITE 203",
            "city": "CARY",
            "state": "NC",
            "postal_code": "275119307",
            "telephone_number": "919-816-0009",
            "fax_number": "919-828-9702"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GONZALEZ-JOHNSON",
        "first_name": "GAYLE",
        "credential": "MSW, LCSW, ACSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-07",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "001027",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cary, NC

Sources for this page

Verify at the official NPI Registry.