Individual provider Active NPI

Addison Gomez, LCSW

  • Clinical Social Worker
  • Evansville, IN
National Provider Identifier
1831074897
Registry record updated Aug 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
34010927A Issued in IN
Practice address
101 N Plaza East Blvd Ste 230
Evansville, IN 47715-2806
Phone
(812) 413-0315
Fax
(812) 909-3001
NPI assigned
Aug 8, 2025
Last updated
Aug 8, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 8, 2025

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 34010927A IN Primary

Addresses

Primary practice location

101 N Plaza East Blvd Ste 230
Evansville, IN 47715-2806

Mailing address

101 N Plaza East Blvd Ste 230
Evansville, IN 47715-2806
Phone (812) 413-0315

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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
I20250919001231 IN Practitioner - Clinical Social Worker 5698279842 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2017
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

101 N Plaza E Blvd
Suite 230
Evansville, IN 47715-2806

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Innerspace Center for Emotional Health LLC CurrentSince Aug 21, 2025 Accepting new patients

Locations

101 N Plaza East Blvd
Ste 230
Evansville, IN 47715
Phone (812) 413-0315

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1754611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754611200000",
    "number": "1831074897",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 N PLAZA EAST BLVD STE 230",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477152806",
            "telephone_number": "812-413-0315",
            "fax_number": "812-093-0019"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 N PLAZA EAST BLVD STE 230",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477152806",
            "telephone_number": "812-413-0315",
            "fax_number": "812-909-3001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOMEZ",
        "first_name": "ADDISON",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-08-08",
        "last_updated": "2025-08-08",
        "certification_date": "2025-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IN",
            "license": "34010927A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Evansville, IN

Sources for this page

Verify at the official NPI Registry.