Mathew J Gossard, LMSW

Primary specialty

Social WorkerTaxonomy code 104100000X

License

6261171 Issued in ID

Practice address

2000 S Eagle Rd
Meridian, ID 83642-6707

Phone

(801) 746-9373

NPI assigned

Sep 10, 2024

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in ID

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

Specialty

Mental Health Counselor

Education

Other, 2024

Medicare assignment

May accept Medicare assignment

Group practices

Azure Stone Mental Health and Wellness LLCGroup PAC ID 5991242059, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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 and National Provider Directory roles.

• Azure Stone Mental Health & Wellness LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Meridian, ID
  • NPI 1922879394
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1725926400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725926400000",
    "number": "1710713441",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2763 N CAMDEN PL",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837045772",
            "telephone_number": "208-861-5704"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2000 S EAGLE RD",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "836426707",
            "telephone_number": "801-746-9373"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOSSARD",
        "first_name": "MATHEW",
        "middle_name": "J",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-09-10",
        "last_updated": "2024-09-10",
        "certification_date": "2024-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "ID",
            "license": "6261171",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Huiyong Chong Goodyear-Fassihi, PMHNP-BC
• Skyler Willow Goonan
• Hailey M Gordon, PA-C
• Judith L Gordon, LPC
• Jessica Gorringe
• Lana Goulart, RBT
• William Dale Goulart
• Linda J Gould, NP
• Nicole Dannielle Gould
• Shannon Gower, AU.D.

• Social Worker in Meridian, ID
• Providers in Meridian, ID by specialty
• Social Worker in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2024; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.