Organization Active NPI

Gottfried Therapist LLC

  • Clinical Social Worker
  • Livonia, MI
National Provider Identifier
1053107151
Registry record updated Apr 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Legal business name
GOTTFRIED THERAPIST LLC
Practice address
31610 Plymouth Rd
Livonia, MI 48150-1930
Phone
(248) 397-5169
Fax
(734) 421-4045
NPI assigned
Apr 16, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 16, 2025

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

Authorized official

Name
Elana M Gottfried, MSWNPI 1972791465
Title
President/Owner
Phone
(248) 885-3903

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 1041C0700X Primary

Addresses

Primary practice location

31610 Plymouth Rd
Livonia, MI 48150-1930

Mailing address

31610 Plymouth Rd
Livonia, MI 48150-1930
Phone (248) 397-5169

Other identifiers 1

IdentifierTypeStateIssuer
6801085388OtherMISTATE LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250605001516 MI Part B Supplier - Clinic/Group Practice 9830608272 Receives reassigned benefits from 1 practitioner
Practice locations: Livonia, MI

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1744761600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1744761600000",
    "number": "1053107151",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "31610 PLYMOUTH RD",
            "city": "LIVONIA",
            "state": "MI",
            "postal_code": "481501930",
            "telephone_number": "248-397-5169",
            "fax_number": "734-421-4045"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "31610 PLYMOUTH RD",
            "city": "LIVONIA",
            "state": "MI",
            "postal_code": "481501930",
            "telephone_number": "248-397-5169",
            "fax_number": "734-421-4045"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GOTTFRIED THERAPIST LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-04-16",
        "last_updated": "2025-04-16",
        "certification_date": "2025-04-16",
        "status": "A",
        "authorized_official_last_name": "GOTTFRIED",
        "authorized_official_first_name": "ELANA",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PRESIDENT/OWNER",
        "authorized_official_telephone_number": "248-885-3903",
        "authorized_official_credential": "MSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "6801085388",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Livonia, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.