James M Gagnon, PHD, MSW, LCSW
Individual provider Active NPI Psychologist · Tallahassee, FL
NPI 1780684274 · NPPES record last updated Feb 25, 2019
Key facts
- NPI
- 1780684274
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Psychologist 103T00000X
- License
- SW4770 (FL)
- Practice address
- 220 Office PLZ
Tallahassee, FL 32301-2808 - Phone
- (850) 877-0205
- Fax
- (850) 877-1129
- NPI assigned
- Jul 26, 2005
- Sex
- Male
- Sole proprietor
- Yes
Medicare Care Compare profile
- Specialty
- Clinical Social Worker
- Education
- Other, 1992
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
220 Office Plaza Dr
Tallahassee, FL 32301-2808
Phone (850) 877-0205
220 Office PLZ
Tallahassee, FL 32301-2808
2910 Kerry Forest Pkwy
D4 224
Talahassee, FL 32309-6828
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in FL
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20101129000665 | FL | Practitioner - Clinical Social Worker | 4587850862 | Practice locations: Talahassee, FL; Tallahassee, FL |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Philosophy
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | SW4770 | FL | Yes |
Addresses
Primary practice location
220 Office PLZ
Tallahassee, FL 32301-2808
Mailing address
220 Office PLZ
Tallahassee, FL 32301-2808
Phone (850) 877-0205
Other providers in Tallahassee, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 25, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.