Individual provider Active NPI

Nichole Potts Gause, LCSW

  • Clinical Social Worker
  • Charlotte, NC
National Provider Identifier
1962823831
Registry record updated Jun 12, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
C008563 Issued in NC
Practice address
2520 Wingdale Dr
Charlotte, NC 28213-5267
Phone
(803) 322-0593
NPI assigned
Dec 19, 2013
Last updated
Jun 12, 2026By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 12, 2026

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 C008563 NC Primary

Addresses

Primary practice location

2520 Wingdale Dr
Charlotte, NC 28213-5267

Mailing address

2520 Wingdale Dr
Charlotte, NC 28213-5267
Phone (803) 322-0593

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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
I20260622002903 NC Practitioner - Clinical Social Worker 6901379924 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1998
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

2261 Market St
San Francisco, CA 94114-1612

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
C008563NCMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Good Life Counseling and Training, PLLC Current Accepting new patients

Organizations & group practices 2

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": "1387411200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1781222400000",
    "number": "1962823831",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2520 WINGDALE DR",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282135267",
            "telephone_number": "803-322-0593"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2520 WINGDALE DR",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282135267",
            "telephone_number": "803-322-0593"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAUSE",
        "first_name": "NICHOLE",
        "middle_name": "POTTS",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-12-19",
        "last_updated": "2026-06-12",
        "certification_date": "2026-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "C008563",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

Verify at the official NPI Registry.