Individual provider Active NPI

Nadine May Gilbert, LCSW

  • Clinical Social Worker
  • Watertown, WI
National Provider Identifier
1003825787
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
783123 Issued in WI
Practice address
763 Milford St
Frontier Mental Health Clinic
Watertown, WI 53094-6021
Phone
(920) 206-6115
Fax
(920) 206-6106
NPI assigned
Aug 5, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 783123 WI Primary

Addresses

Primary practice location

763 Milford St
Frontier Mental Health Clinic
Watertown, WI 53094-6021

Mailing address

3695 Dominic Dr
Brookfield, WI 53045-1414
Phone (262) 781-4434

Other identifiers 1

IdentifierTypeStateIssuer
40988800MedicaidWI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
783123WIMDClinical Social Worker
783WIMDMedical Physician Assistant

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1154736000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1003825787",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3695 DOMINIC DR",
            "city": "BROOKFIELD",
            "state": "WI",
            "postal_code": "530451414",
            "telephone_number": "262-781-4434"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "763 MILFORD ST",
            "address_2": "FRONTIER MENTAL HEALTH CLINIC",
            "city": "WATERTOWN",
            "state": "WI",
            "postal_code": "530946021",
            "telephone_number": "920-206-6115",
            "fax_number": "920-206-6106"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GILBERT",
        "first_name": "NADINE",
        "middle_name": "MAY",
        "name_prefix": "Miss",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-05",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WI",
            "license": "783123",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "40988800",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Watertown, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.