Gayle D Goldblatt, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

L3121 Issued in OR

Practice address

1957 Thompson Rd
Coos Bay, OR 97420-2040

Phone

(541) 266-8575

Fax

(541) 269-7656

NPI assigned

Jul 14, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in OR

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

Specialty

Clinical Social Worker

Education

Other, 1980

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1152835200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1375315200000",
    "number": "1912923848",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1957 THOMPSON RD",
            "city": "COOS BAY",
            "state": "OR",
            "postal_code": "974202040",
            "telephone_number": "541-266-8575",
            "fax_number": "541-269-7656"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1957 THOMPSON RD",
            "city": "COOS BAY",
            "state": "OR",
            "postal_code": "974202040",
            "telephone_number": "541-266-8575",
            "fax_number": "541-269-7656"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOLDBLATT",
        "first_name": "GAYLE",
        "middle_name": "D",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-14",
        "last_updated": "2013-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OR",
            "license": "L3121",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jessica Ellen Glazier
• Deana Marie Goalder
• Danielle Goette, LMT, DOULA
• Gold Path Therapy LLC
• Marshall Goldberg, D.D.S., M.S.D.
• Kylie Gomes
• Paul Gonzales, CRM
• Atta Goudarzi, MD
• Grace and Hope Counseling, LLC
• Ciera Lorraine Gray, FNP

• Clinical Social Worker in Coos Bay, OR
• Providers in Coos Bay, OR by specialty
• Clinical Social Worker in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.