First State Employment Services

Primary specialty

Rehabilitation PsychologistTaxonomy code 103TR0400X

Legal business name

FIRST STATE EMPLOYMENT SERVICES

Practice address

524 Harlan Blvd
Wilmington, DE 19801-5166

Phone

(302) 250-5883

Fax

(302) 984-3329

NPI assigned

May 14, 2018

Organization subpart

No

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

Authorized official

Name

Mr. Clinton Gangloff

Title

President and Ceo

Phone

(302) 383-0191

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1526256000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1526256000000",
    "number": "1023508322",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "524 HARLAN BLVD",
            "city": "WILMINGTON",
            "state": "DE",
            "postal_code": "198015166",
            "telephone_number": "302-250-5883",
            "fax_number": "302-984-3329"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "524 HARLAN BLVD",
            "city": "WILMINGTON",
            "state": "DE",
            "postal_code": "198015166",
            "telephone_number": "302-250-5883",
            "fax_number": "302-984-3329"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FIRST STATE EMPLOYMENT SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-05-14",
        "last_updated": "2018-05-14",
        "status": "A",
        "authorized_official_last_name": "GANGLOFF",
        "authorized_official_first_name": "CLINTON",
        "authorized_official_title_or_position": "PRESIDENT AND CEO",
        "authorized_official_telephone_number": "302-383-0191",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "103TR0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Rehabilitation",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Rehabilitation Psychologist in Wilmington, DE
• Providers in Wilmington, DE by specialty
• Rehabilitation Psychologist in Delaware

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2018; 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.