Active NPI
Deborah Gorman, LCSW-R
- Clinical Social Worker
- Hudson Falls, NY
National Provider Identifier
1730193418
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 00061648
- Practice address
- 3043 State Route 4
Hudson Falls, NY 12839-9632 - Phone
- (518) 747-2284
- Fax
- (518) 747-2253
- NPI assigned
- Jul 28, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 00061648 | NY | Primary |
Addresses
Primary practice location
3043 State Route 4
Hudson Falls, NY 12839-9632
Mailing address
3043 State Route 4
Hudson Falls, NY 12839-9632
Phone (518) 747-2284
Other identifiers 11
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000409117001 | Other | EMPIRE BC/BS | |
| P01430434 | Other | NY | MEDICARE RAIL ROAD |
| 040426031840 | Other | FIDELIS | |
| 000409117001 | Other | MEDICARE SENIOR BLUE | |
| 000409117001 | Other | BLUE SHIELD OF NORTHEASTERN NEW YORK | |
| 11623959 | Other | CAQH | |
| 000409117001 | Other | HEALTHNOW INTEGRATED | |
| NH1731 | Other | BC/BS | |
| 000409117001 | Other | EMPIRE BC/BS BLUE CARD | |
| 00069274 | Medicaid | NY | |
| 53088 | Other | MVP |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 00061648 | NY | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1154044800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1429747200000",
"number": "1730193418",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3043 STATE ROUTE 4",
"city": "HUDSON FALLS",
"state": "NY",
"postal_code": "128399632",
"telephone_number": "518-747-2284",
"fax_number": "518-747-2253"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3043 STATE ROUTE 4",
"city": "HUDSON FALLS",
"state": "NY",
"postal_code": "128399632",
"telephone_number": "518-747-2284",
"fax_number": "518-747-2253"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GORMAN",
"first_name": "DEBORAH",
"credential": "LCSW-R",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-07-28",
"last_updated": "2015-04-23",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "NY",
"license": "00061648",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "EMPIRE BC/BS",
"identifier": "000409117001",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE RAIL ROAD",
"identifier": "P01430434",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "FIDELIS",
"identifier": "040426031840",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE SENIOR BLUE",
"identifier": "000409117001",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE SHIELD OF NORTHEASTERN NEW YORK",
"identifier": "000409117001",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CAQH",
"identifier": "11623959",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTHNOW INTEGRATED",
"identifier": "000409117001",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BC/BS",
"identifier": "NH1731",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "EMPIRE BC/BS BLUE CARD",
"identifier": "000409117001",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00069274",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MVP",
"identifier": "53088",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Hudson Falls, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.