Individual provider Active NPI

Abigail Goskeson, LICSW

  • Clinical Social Worker
  • Albert Lea, MN
National Provider Identifier
1902469562
Registry record updated Jan 12, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
17779 Issued in MN
Practice address
123 S Newton Ave
Albert Lea, MN 56007-2524
Phone
(507) 383-6872
NPI assigned
Apr 19, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 12, 2021

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 17779 MN Primary

Addresses

Primary practice location

123 S Newton Ave
Albert Lea, MN 56007-2524

Mailing address

1625 Massee St
Albert Lea, MN 56007-5780
Phone (507) 383-6872

Other practice location 1

907 Sykes St
Albert Lea, MN 56007-3405
Phone (507) 377-8506

Other names 1

  • Abigail Goskeson Professional name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
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
I20190626002704 MN Practitioner - Clinical Social Worker 9133453012 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

244 W Clark St
Albert Lea, MN 56007-2548
Phone (507) 473-3995

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
17779MNMDAddiction Medicine (Internal Medicine) Physician

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.

NPI Registry JSON

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

{
    "created_epoch": "1555632000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1610409600000",
    "number": "1902469562",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1625 MASSEE ST",
            "city": "ALBERT LEA",
            "state": "MN",
            "postal_code": "560075780",
            "telephone_number": "507-383-6872"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "123 S NEWTON AVE",
            "city": "ALBERT LEA",
            "state": "MN",
            "postal_code": "560072524",
            "telephone_number": "507-383-6872"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "907 Sykes St",
            "address_purpose": "LOCATION",
            "city": "Albert Lea",
            "state": "MN",
            "postal_code": "560073405",
            "country_code": "US",
            "telephone_number": "507-377-8506",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GOSKESON",
        "first_name": "ABIGAIL",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-04-19",
        "last_updated": "2021-01-12",
        "certification_date": "2021-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "17779",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ABIGAIL",
            "last_name": "GOSKESON",
            "credential": "LICSW",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Albert Lea, MN

Sources for this page

Verify at the official NPI Registry.