Keith Terence Gostel, LCSW
Individual provider Active NPI Clinical Social Worker · Quinton, VA
NPI 1982018354 · NPPES record last updated Jun 13, 2014
Key facts
- NPI
- 1982018354
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Social Worker 1041C0700X
- License
- 0904002481 (VA)
- Practice address
- 3601 Locust CT
Quinton, VA 23141-1577 - Phone
- (804) 932-8170
- Fax
- (804) 520-8007
- NPI assigned
- Jun 13, 2014
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in VA
- Eligible to order & refer
- Part B services: No · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20141107001905 | VA | Practitioner - Clinical Social Worker | 5193947075 | Practice locations: Quinton, VA |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0904002481 | VA | MD | Clinical Social Worker |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 0904002481 | VA | Yes |
Addresses
Primary practice location
3601 Locust CT
Quinton, VA 23141-1577
Mailing address
3601 Locust CT
Quinton, VA 23141-1577
Phone (804) 932-8170
Other providers in Quinton, VA
- Food Lion LLC
- Refka Ghattas
- Anup J Gokli
- Suzanna Hunter Goode
- Elizabeth Ann Gordon
- Phyllis Gee Sum Greer
- Wendy Gail Hall
- Theresa Hayes
- Heal Health Orthopaedics and Urgent Care Clinics PLLC
- Krysten Marie Herrero
All providers in Quinton, VA · Clinical Social Worker in Virginia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 13, 2014. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.