Individual provider Active NPI

Mary Ann Goss, LMSW

  • Case Manager/Care Coordinator
  • Shreveport, LA
National Provider Identifier
1821375445
Registry record updated May 29, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Case Manager/Care CoordinatorTaxonomy code 171M00000X
Practice address
2800 Youree Dr Ste 120
Shreveport, LA 71104-3667
Phone
(318) 671-4341
Fax
(318) 220-4039
NPI assigned
Nov 10, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 29, 2019

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 8

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 5194 LA
Professional Counselor 101YP2500X 5194 LA
Addiction (Substance Use Disorder) Psychologist 103TA0400X 5194 LA
Group Psychotherapy Psychologist 103TP2701X 5194 LA
Clinical Social Worker 1041C0700X 5194 LA
Marriage & Family Therapist 106H00000X 5194 LA
Case Manager/Care Coordinator 171M00000X
Case Manager/Care Coordinator 171M00000X LA Primary

Addresses

Primary practice location

2800 Youree Dr Ste 120
Shreveport, LA 71104-3667

Mailing address

2800 Youree Dr Ste 120
Shreveport, LA 71104-3667
Phone (318) 671-4341

Other practice location 1

252 Division St
Mansfield, LA 71052-4106
Phone (318) 461-8009

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
5194LAMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1320883200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1559088000000",
    "number": "1821375445",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2800 YOUREE DR STE 120",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711043667",
            "telephone_number": "318-671-4341",
            "fax_number": "318-220-4039"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2800 YOUREE DR STE 120",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711043667",
            "telephone_number": "318-671-4341",
            "fax_number": "318-220-4039"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "252 Division St",
            "address_purpose": "LOCATION",
            "city": "Mansfield",
            "state": "LA",
            "postal_code": "710524106",
            "country_code": "US",
            "telephone_number": "318-461-8009",
            "fax_number": "318-635-1668",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GOSS",
        "first_name": "MARY",
        "middle_name": "ANN",
        "name_prefix": "Ms.",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-11-10",
        "last_updated": "2019-05-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "LA",
            "license": "5194",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "LA",
            "license": "5194",
            "primary": false
        },
        {
            "code": "103TA0400X",
            "taxonomy_group": "",
            "desc": "Psychologist, Addiction (Substance Use Disorder)",
            "state": "LA",
            "license": "5194",
            "primary": false
        },
        {
            "code": "103TP2701X",
            "taxonomy_group": "",
            "desc": "Psychologist, Group Psychotherapy",
            "state": "LA",
            "license": "5194",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "LA",
            "license": "5194",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "LA",
            "license": "5194",
            "primary": false
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "LA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shreveport, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.