MR. TIM DUANE GOUGH JR. LCSW-C
NPI 1457085037
Social Worker - Clinical in North East, MD
About Mr. Tim Duane Gough Jr. Lcsw-c NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
MR. TIM DUANE GOUGH JR. LCSW-C (NPI 1457085037) is an individual clinical provider in North East, Maryland, licensed in Maryland (28745) and active in the NPI registry since July 2022. He is enrolled in Medicare PECOS and is a graduate of Other (2022).
NPPES Registry Identity
Specialties & Licenses
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare and accepts Medicare assignment
Mr. Tim Duane Gough Jr. Lcsw-c 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.
Medicare Billing Reassignment
Medicare enrollment records show Tim Gough reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
North East, MD 21901
- Reassigned Medicare billing, Maryland enrollment
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 21901 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
Other Providers at the Same Location NPPES 5
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
NORTH EAST, MD 21901
NORTH EAST, MD 21901
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Tim Gough's NPI number?
The NPI number for Tim Gough is 1457085037. It was assigned to this individual provider in the NPPES registry on July 11, 2022.
Where is Tim Gough located?
Tim Gough practices at 102 E Cecil Ave Ste B, North East, MD 21901. The listed phone number is (667) 231-1269.
What is Tim Gough's specialty?
The primary specialty registered for this NPI is Social Worker, specializing in Clinical, with taxonomy code 1041C0700X.
Is Tim Gough enrolled in Medicare?
Yes. Tim Gough is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.
Which organization bills Medicare for Tim Gough's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Tim Gough reassigns Medicare benefits to Thriving Minds Therapy, LLC (North East, MD). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Tim Gough's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
When was this NPI record last updated?
The NPPES record for Tim Gough was last updated on December 19, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 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.
# Mr. Tim Duane Gough Jr., LCSW-C · NPI 1457085037
Clinical provider in North East, Maryland. Individual provider, active in the CMS NPPES registry since July 11, 2022.
## Identity
- **NPI:** 1457085037 (Entity type: Individual)
- **Enumerated:** July 11, 2022
- **Primary specialty:** Social Worker - Clinical · taxonomy 1041C0700X
- **State license:** 28745 (Maryland)
- **Sole proprietor:** Yes
## Practice location
- **Address:** 102 E CECIL AVE STE B, North East, MD 21901-4057
- **Phone:** (667) 231-1269
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment
- **Bills Medicare through:** Thriving Minds Therapy, LLC (NPI 1679370159, North East, MD), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 2022
## Record status
- **NPPES last updated:** December 19, 2025
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Source: [NPI Profile](https://npiprofile.com/npi/1457085037) · Data from the CMS NPPES public registry.