Mr Tim Duane Gough Jr, LCSW-C in North East, MD - Medicare Social Worker Provider

Mr Tim Duane Gough Jr, LCSW-C is a medicare enrolled "Social Worker - Clinical" provider in North East, Maryland. His current practice location is 102 E Cecil Ave Ste B, North East, Maryland. You can reach out to his office (for appointments etc.) via phone at (667) 231-1269.

Mr Tim Duane Gough Jr is licensed to practice in Maryland (license number 28745) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1457085037.

Contact Information

	Mr Tim Duane Gough Jr, LCSW-C
	102 E Cecil Ave Ste B, North East, MD 21901-4057
	(667) 231-1269
	Not Available

Map and Direction

Healthcare Provider's Profile

Full Name	Mr Tim Duane Gough Jr
Gender	Male
Speciality	Social Worker - Clinical
Location	102 E Cecil Ave Ste B, North East, Maryland
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1457085037
Provider Enumeration Date: 07/11/2022
Last Update Date: 06/20/2025

Medicare PECOS Information:

PECOS PAC ID: 3375067416
Enrollment ID: I20250421002428

Medical Identifiers

Medical identifiers for Mr Tim Duane Gough Jr such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1457085037	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
1041C0700X	Social Worker - Clinical	28745 (Maryland)	Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Mr Tim Duane Gough Jr allows following entities to bill medicare on his behalf.

Entity Name	Thriving Minds Therapy, Llc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1679370159 PECOS PAC ID: 2466976501 Enrollment ID: O20250410000127

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Mr Tim Duane Gough Jr is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Mr Tim Duane Gough Jr, LCSW-C 102 E Cecil Ave Ste B, North East, MD 21901-4057 Ph: (667) 231-1269	Mr Tim Duane Gough Jr, LCSW-C 102 E Cecil Ave Ste B, North East, MD 21901-4057 Ph: (667) 231-1269

Reviews and Comments

Social Worker in North East, MD

Virginia R Lanczkowski, Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 101 Mill Ln, North East, MD 21901 Phone: 410-287-6569
Constance Muller-thym, LCSW-C Clinical Social Worker Medicare: Accepting Medicare Assignments Practice Location: 101 Mill Ln, North East, MD 21901 Phone: 410-287-6569 Fax: 410-287-8949
Elizabeth Grace Wolf, LCSW Clinical Social Worker Medicare: Medicare Enrolled Practice Location: 12 Old York Ct, North East, MD 21901 Phone: 802-498-3735
Ann Gonzalez, LMSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 2057 Pulaski Hwy Ste 4, North East, MD 21901 Phone: 732-599-9932
Ms. Carolyn Marie Wells, LCPC Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 1930 Turkey Point Rd, North East, MD 21901 Phone: 410-287-5235 Fax: 410-287-2556
Robyn Marie Boettner Hunt, LCSW-C Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 31 Bay View Woods Loop, North East, MD 21901 Phone: 443-854-4257

Mr Tim Duane Gough Jr, LCSW-C - Medicare Clinical Social Worker in North East, MD