Individual provider Active NPI

Megan Gougeon, LMSW

  • Clinical Social Worker
  • Clarkston, MI
National Provider Identifier
1942914999
Registry record updated Mar 31, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6801119640 Issued in MI
Practice address
39 S Main St Ste 4
Clarkston, MI 48346-1593
Phone
(313) 473-0150
NPI assigned
Jan 12, 2023
Last updated
Mar 31, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 31, 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 6801119640 MI Primary

Addresses

Primary practice location

39 S Main St Ste 4
Clarkston, MI 48346-1593

Mailing address

39 S Main St Ste 4
Clarkston, MI 48346-1593
Phone (313) 473-0150

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20250630000496 MI Practitioner - Clinical Social Worker 3173036696 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
University of Michigan Medical School, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

39 S Main St
Suite 4
Clarkston, MI 48346-1593
Phone (313) 473-0151

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6801119640MIMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Blue Sky Mind LLC Clinical CurrentSince Apr 30, 2025 Accepting new patients

Locations

39 S Main St
Ste 4
Clarkston, MI 48346
Phone (313) 473-0150

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": "1673481600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743379200000",
    "number": "1942914999",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "39 S MAIN ST STE 4",
            "city": "CLARKSTON",
            "state": "MI",
            "postal_code": "483461593",
            "telephone_number": "313-473-0150"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "39 S MAIN ST STE 4",
            "city": "CLARKSTON",
            "state": "MI",
            "postal_code": "483461593",
            "telephone_number": "313-473-0150"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOUGEON",
        "first_name": "MEGAN",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-01-12",
        "last_updated": "2025-03-31",
        "certification_date": "2025-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801119640",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clarkston, MI

Sources for this page

Verify at the official NPI Registry.