Individual provider Active NPI

Timothy Scott Gobek, LCSW

  • Clinical Social Worker
  • Gary, IN
National Provider Identifier
1730487273
Registry record updated Oct 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
34001571A Issued in IN
Practice address
4900 Broadway
Gary, IN 46408-4605
Phone
(219) 237-5170
Fax
(219) 321-1931
NPI assigned
Mar 8, 2011
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 1, 2024

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 34001571A IN Primary

Addresses

Primary practice location

4900 Broadway
Gary, IN 46408-4605

Mailing address

PO Box 746721
Atlanta, GA 30374-6721
Phone (312) 733-9730

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
34001571AINMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Sondermind Provider Network LLC Clinical CurrentSince Jul 26, 2023 Accepting new patients
Paige Maddex & Associates LLC Clinical CurrentSince Jul 31, 2023 Accepting new patients
Vitae Health Medical Indiana LLC Clinical CurrentSince Feb 3, 2022 Accepting new patients
Main Street Counseling Center CurrentSince Dec 23, 2021 Accepting new patients
Osh-in Physicians Group, PC Past Accepting new patients
Jain Counseling Services Inc. Clinical PastSince Oct 1, 2023 Accepting new patients
Osh-Oh Physicians Group PC Clinical PastSince Oct 1, 2022 Accepting new patients

Locations

303 E Wacker Dr
Ste 1127
Chicago, IL 60601
Phone (312) 328-2347

119 E Goldsborough St
Ste A
Crown Point, IN 46307
Phone (219) 663-0888

10352 N 600 E
Demotte, IN 46310
Phone (219) 345-5211

333 N Alabama St
Ste 350
Indianapolis, IN 46204
Phone (317) 983-0002

5 Lincolnway
Ste 2
Valparaiso, IN 46383
Phone (219) 221-4022

Organizations & group practices 7

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.

NPI Registry JSON

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

{
    "created_epoch": "1299542400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727740800000",
    "number": "1730487273",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 746721",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303746721",
            "telephone_number": "312-733-9730",
            "fax_number": "312-929-0373"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4900 BROADWAY",
            "city": "GARY",
            "state": "IN",
            "postal_code": "464084605",
            "telephone_number": "219-237-5170",
            "fax_number": "219-321-1931"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOBEK",
        "first_name": "TIMOTHY",
        "middle_name": "SCOTT",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-03-08",
        "last_updated": "2024-10-01",
        "certification_date": "2024-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IN",
            "license": "34001571A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gary, IN

Sources for this page

Verify at the official NPI Registry.