Shelly Sue Goscha, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

80263 Issued in CA

Practice address

5170 Golden Foothill Pkwy
El Dorado Hills, CA 95762-9608

Phone

(785) 766-1885

Fax

(916) 235-5843

NPI assigned

Nov 12, 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

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CA

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

Clinical Social Worker

Education

Other, 1995

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Shelly Goscha, Licensed Clinical Social Worker, Psychotherapy Servic

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • El Dorado Hills, CA
  • NPI 1215530167
  Medicare reassignment NPD Authorized official
• Cameron Park Counseling Center, Inc.

  dba Cameron Park Counseling Center

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Cameron Park, CA
  • NPI 1477760874

  Clinical

  Medicare reassignment NPD
• Cameron Park Counseling Center

  • Point of Service
  • Cameron Park, CA
  • NPI 1093104325
  NPD (past)

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

{
    "created_epoch": "1384214400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1613779200000",
    "number": "1750711719",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "414 ASHLAND CT",
            "city": "CAMERON PARK",
            "state": "CA",
            "postal_code": "956827661",
            "telephone_number": "785-766-1885",
            "fax_number": "916-235-5843"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5170 GOLDEN FOOTHILL PKWY",
            "city": "EL DORADO HILLS",
            "state": "CA",
            "postal_code": "957629608",
            "telephone_number": "785-766-1885",
            "fax_number": "916-235-5843"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOSCHA",
        "first_name": "SHELLY",
        "middle_name": "SUE",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-11-12",
        "last_updated": "2021-02-20",
        "certification_date": "2021-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "80263",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "KS",
            "license": "1980",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1750711719",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Maya Gonzalez
• Meghan Gonzalez
• Norma Gonzalez
• Glenda Darlene Goodwin, M.D.
• Jayda Gordon
• Claire Maurenn Goss
• Lauren Grace
• Reanna Grant
• Shawnice Odetta Graybill
• Jonah Graziano

• Clinical Social Worker in El Dorado Hills, CA
• Providers in El Dorado Hills, CA by specialty
• Clinical Social Worker in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2021; 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.