Gwen Lotta, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

6309 Issued in ND

Practice address

3674 S Washington St
Grand Forks, ND 58201-5766

Phone

(701) 205-3000

Fax

(701) 732-2501

NPI assigned

Mar 13, 2020

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in ND, MN, AK, SD, TX, MT, NY7 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 7

Specialty

Clinical Social Worker

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Peterson Medical Clinics LLCGroup PAC ID 9335412220, 91 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Peterson Medical Clinics, LLC

  • Multi-Specialty Clinic/Center
  • Grand Forks, ND
  • NPI 1699295774

  AK, MN, MT, ND, NY, SD

  Medicare reassignment Care Compare group NPD
• Bristol Bay Area Health Corporation

  • Clinic/Center
  • Aleknagik North, AK
  • NPI 1235291246

  TX

  Medicare reassignment NPD
• Norton Sound Health Corporation

  • Critical Access Hospital
  • Nome, AK
  • NPI 1154358232

  AK

  Medicare reassignment NPD
• Norton Sound Health Corporation

  • Critical Access Hospital
  • Nome, AK
  • NPI 1225101041

  AK

  Medicare reassignment NPD
• Eastern Aleutian Tribes, Inc

  • Community Health Clinic/Center
  • King Cove, AK
  • NPI 1649332446

  TX

  Medicare reassignment NPD (past)
• Bristol Bay Area Health Corporation

  • Clinic/Center
  • Koliganek, AK
  • NPI 1013079607
  NPD
• Bristol Bay Area Health Corporation

  • Clinic/Center
  • Ekwok, AK
  • NPI 1104988799
  NPD
• Bristol Bay Area Health Corporation

  • Clinic/Center
  • Pilot Point, AK
  • NPI 1174683825
  NPD
• Bristol Bay Area Health Corporation

  • Clinic/Center
  • Platinum, AK
  • NPI 1285796870
  NPD
• Bristol Bay Area Health Corporation

  • Clinic/Center
  • Levelock, AK
  • NPI 1366502767
  NPD
• Bristol Bay Area Health Corporation

  • Clinic/Center
  • South Naknek, AK
  • NPI 1417018193
  NPD
• Bristol Bay Area Health Corporation

  • Clinic/Center
  • Twin Hills, AK
  • NPI 1487716825
  NPD

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

{
    "created_epoch": "1584057600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1784073600000",
    "number": "1053947796",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5210",
            "city": "GRAND FORKS",
            "state": "ND",
            "postal_code": "582065210",
            "telephone_number": "701-205-3000",
            "fax_number": "701-732-2501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3674 S WASHINGTON ST",
            "city": "GRAND FORKS",
            "state": "ND",
            "postal_code": "582015766",
            "telephone_number": "701-205-3000",
            "fax_number": "701-732-2501"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOTTA",
        "first_name": "GWEN",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-03-13",
        "last_updated": "2026-07-15",
        "certification_date": "2026-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NY",
            "license": "096785",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "ND",
            "license": "6309",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kateri Long
• Dustin Longie
• Hallie Longtin, OTD, OTR/L
• Alison Looby, PH.D.
• Jane Ann Loscheider, OT
• Vanessa Loughead
• Nicole T Louthain, BS, CM
• Nicole Eleanor J Lovat, M.D.
• Sara Marie Lovejoy, M.S. CCC-SLP
• Nina Lovell, LBSW

• All providers in Grand Forks, ND
• Clinical Social Worker in North Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.