Kathleen Mary Gomes, MS, CAS

Individual provider Active NPI Addiction (Substance Use Disorder) Counselor · Shallotte, NC

NPI 1891844486 · NPPES record last updated Sep 21, 2012

Key facts

NPI
1891844486
Entity type
Individual (NPI type 1)
Primary specialty
Addiction (Substance Use Disorder) Counselor 101YA0400X
License
349 (NC)
Practice address
120 Coastal Horizons Dr
Shallotte, NC 28470-6094
Phone
(910) 754-4515
NPI assigned
Jan 10, 2007
Sex
Female
Sole proprietor
No

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 and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
S3928NCMDMental Health Counselor
000227CTMDClinical Social Worker
930NCMDMarriage & Family Therapist
349NCMDAcupuncturist

Practice roles

OrganizationSpecialtyStatusNew patients
Palms Health and Wellness,LLC Addiction (Substance Use Disorder) Current Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 349 NC Yes
Mental Health Counselor 101YM0800X S3928 NC
Marriage & Family Therapist 106H00000X 930 NC
Marriage & Family Therapist 106H00000X 000227 CT

Addresses

Primary practice location

120 Coastal Horizons Dr
Shallotte, NC 28470-6094

Mailing address

1919 Stone Ballast Way
Ocean Isle Beach, NC 28469
Phone (910) 754-3782

Other providers in Shallotte, NC

All providers in Shallotte, NC · Addiction (Substance Use Disorder) Counselor in North Carolina

Sources for this page

Verify at the official NPI Registry.