AMANDA A GOUGH MLSW
NPI 1174172159
Social Worker - Clinical in Traverse City, MI

Q: What is Amanda Gough's NPI number?

The NPI number for Amanda Gough is 1174172159. It was assigned to this individual provider in the NPPES registry on September 11, 2019.

Q: What is Amanda Gough's specialty?

The primary specialty registered for this NPI is Social Worker, specializing in Clinical, with taxonomy code 1041C0700X.

Q: When was this NPI record last updated?

The NPPES record for Amanda Gough was last updated on February 16, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since September 11, 2019PECOS EnrolledAccepts Medicare Assignment

3298 VETERANS DR, TRAVERSE CITY, MI 49684(231) 715-8466(231) 943-2263 Get Directions Write a Review

NPPES record last updated: February 16, 2026. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Jul 5, 2024, Oct 1, 2019, Sep 11, 2019 (3 updates tracked since 2019).

On this page

About Amanda A Gough Mlsw NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

AMANDA A GOUGH MLSW (NPI 1174172159) is an individual clinical provider in Traverse City, Michigan, licensed in Michigan (6801105682) and active in the NPI registry since September 2019. She is enrolled in Medicare PECOS and is a graduate of Other (2019).

NPPES Registry Identity

NPI1174172159

Entity TypeIndividualFemale

Primary Taxonomy1041C0700X

Provider Legal NameAMANDA A GOUGHCredential: MLSW

Location Address3298 VETERANS DRTraverse City, MI 49684-4725

Mailing Address3298 Veterans DrTraverse City, MI 49684-4725 · (231) 715-8466 · Fax (231) 943-2263

Phone(231) 715-8466

Fax(231) 943-2263

Sole ProprietorYes

Medical School CMSOtherGraduated 2019

Enumeration DateSeptember 11, 2019

Last NPPES UpdateFebruary 16, 20263 updates tracked since enumeration

NPPES CertifiedFebruary 16, 2026

✔ NPI 1174172159 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySocial Worker · ClinicalBehavioral Health & Social Service Providers

Taxonomy Code1041C0700X

License✔ Licensed in MI · 6801105682

Definition

A social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances.

3298 VETERANS DR, Traverse City, MI 49684

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Other Identifiers 1

Medicaid1174172159MI

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Care Network of Michigan, Blue Cross Blue Shield of Michigan Mutual Insurance Company, Priority Health.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Amanda A Gough Mlsw is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID1456895200

PECOS Enrollment IDI20240703001527

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 49684 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$0.00 typical visit price

range $54.34 – $166.68

Typical copayment $0.00 (range $13.58 – $41.67)

Most-billed visit code NA

Established Patient

$68.07 typical visit price

range $17.09 – $135.40

Typical copayment $17.01 (range $4.27 – $33.85)

Most-billed visit code 99213

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 7

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MRS. LISA LEDERER LMSW

Social Worker (Clinical)