Individual provider Active NPI

Cassandra Gouldthread, LSW

  • Social Worker
  • Du Bois, PA
National Provider Identifier
1841659398
Registry record updated Nov 3, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
SW133130 Issued in PA
Practice address
1759 Treasure LK
Du Bois, PA 15801-9046
Phone
(814) 771-1343
NPI assigned
Feb 12, 2016
Last updated
Nov 3, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 3, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X SW133130 PA Primary

Addresses

Primary practice location

1759 Treasure LK
Du Bois, PA 15801-9046

Mailing address

54 Blackberry St
Weedville, PA 15868-3510
Phone (814) 771-1343

Other identifiers 1

IdentifierTypeStateIssuer
1841289733OtherPAUBH

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
SW133130PAMDSocial Worker

NPI Registry JSON

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

{
    "created_epoch": "1455235200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1667433600000",
    "number": "1841659398",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "54 BLACKBERRY ST",
            "city": "WEEDVILLE",
            "state": "PA",
            "postal_code": "158683510",
            "telephone_number": "814-771-1343"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1759 TREASURE LK",
            "city": "DU BOIS",
            "state": "PA",
            "postal_code": "158019046",
            "telephone_number": "814-771-1343"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOULDTHREAD",
        "first_name": "CASSANDRA",
        "name_prefix": "Miss",
        "credential": "LSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-02-12",
        "last_updated": "2022-11-03",
        "certification_date": "2022-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "PA",
            "license": "SW133130",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UBH",
            "identifier": "1841289733",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Du Bois, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2022; 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.