Individual provider Active NPI

Susan Goggins, LCSW

  • Clinical Social Worker
  • Cullman, AL
National Provider Identifier
1780628651
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
0709G Issued in AL
Practice address
1909 Commerce Ave
Cullman, AL 35055-6151
Phone
(256) 734-4688
Fax
(256) 736-5638
NPI assigned
Jun 15, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 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 0709G AL Primary

Addresses

Primary practice location

1909 Commerce Ave
Cullman, AL 35055-6151

Mailing address

580 Powell Chapel Rd
Falkville, AL 35622-6219
Phone (256) 739-9354

Other identifiers 1

IdentifierTypeStateIssuer
51505176OtherALBCBS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
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
I20070606000259 AL Practitioner - Clinical Social Worker 2961500517 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Restoration Counseling Services, LLCGroup PAC ID 2466861901, 4 clinicians

Practice addresses (Care Compare)

2014 2ND Ave NW
Cullman, AL 35058-0464
Phone (256) 735-8152

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0709GALMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Restoration Counseling Services, LLC Clinical CurrentSince Jan 10, 2022 Accepting new patients
Alabama Psychiatric Services PC Past Accepting new patients

Locations

1528 Peachtree Ln NW
Ste 104
Cullman, AL 35058
Phone (256) 385-2539

2014 2nd Ave NW
Cullman, AL 35058
Phone (256) 735-8152

Organizations & group practices 2

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": "1150329600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1780628651",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "580 POWELL CHAPEL RD",
            "city": "FALKVILLE",
            "state": "AL",
            "postal_code": "356226219",
            "telephone_number": "256-739-9354"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1909 COMMERCE AVE",
            "city": "CULLMAN",
            "state": "AL",
            "postal_code": "350556151",
            "telephone_number": "256-734-4688",
            "fax_number": "256-736-5638"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOGGINS",
        "first_name": "SUSAN",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-06-15",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "AL",
            "license": "0709G",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "51505176",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cullman, AL

Sources for this page

Verify at the official NPI Registry.