Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

MS. Marilyn A Gora Fong, LICSW

Individual provider Clinical Social Worker · NPI 1174673412

MS. Marilyn A Gora Fong, LICSW is a Clinical Social Worker in Providence, Rhode Island. Qualified in 1983, 43 years ago. Accepts Medicare assignment. Licensed in Massachusetts.

Years since qualifying
43
Licensed in
MA
In the registry since
2007
What do these letters mean?
LICSW — Licensed Independent Clinical Social Worker
The title some states use for an independently practising clinical social worker.

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Practice location Address checks out

12 Sarah St
Providence, RI 02906-2821
Phone: (508) 235-7337
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinical Social Worker (primary) Taxonomy 1041C0700X (MA)

Record details

NPI number1174673412
Entity typeIndividual (Type 1)
GenderFemale
Credentials LICSW
Sole proprietorNo
NPI enumeratedJanuary 11, 2007
Last updated in NPPESJanuary 2, 2025
Certification dateJanuary 2, 2025

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyCLINICAL SOCIAL WORKER
Medical schoolOTHER
Graduated 1983 (43 years in practice)
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations3 on file with Medicare

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