Marikay T Gazda, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

149.004372 Issued in IL

Practice address

12251 S 80TH Ave
Palos Heights, IL 60463-1256

Phone

(708) 923-4941

Fax

(708) 923-5018

NPI assigned

Mar 3, 2017

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1488499200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1489104000000",
    "number": "1023558582",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12251 S 80TH AVE",
            "address_2": "SUITE 1630",
            "city": "PALOS HEIGHTS",
            "state": "IL",
            "postal_code": "604631256",
            "telephone_number": "708-923-5173",
            "fax_number": "708-923-5018"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12251 S 80TH AVE",
            "city": "PALOS HEIGHTS",
            "state": "IL",
            "postal_code": "604631256",
            "telephone_number": "708-923-4941",
            "fax_number": "708-923-5018"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAZDA",
        "first_name": "MARIKAY",
        "middle_name": "T",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-03-03",
        "last_updated": "2017-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149.004372",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tylor Lawrence Gauger, DDS
• Uma Devi Gavani, MD
• Ruthie Celestine Gavin, FNP-BC
• Sally A Gaw, M.S. CCC/SLP
• Ryan Jon Gawron, D.C
• Christopher Miracle Gbunnor
• Ellen Fay Geddes, PSYD.
• James E Geiger Jr., DPM
• Robert Gelles, D.P.M.
• Gema, Inc.

• Clinical Social Worker in Palos Heights, IL
• Providers in Palos Heights, IL by specialty
• Clinical Social Worker in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2017; 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.