Individual provider Active NPI

Gary V Marquardt, LLMSW

  • Clinical Social Worker
  • Houghton, MI
National Provider Identifier
1063847408
Registry record updated Sep 4, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6801094712 Issued in MI
Practice address
901 W Mem Dr
Houghton, MI 49931-2475
Phone
(906) 482-9404
NPI assigned
Sep 4, 2013
Last updated
Sep 4, 2013By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 4, 2013

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 6801094712 MI Primary

Addresses

Primary practice location

901 W Mem Dr
Houghton, MI 49931-2475

Mailing address

901 W Mem Dr
Houghton, MI 49931-2475
Phone (906) 482-9404

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
6801094712MIMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1378252800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1378252800000",
    "number": "1063847408",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "901 W MEM DR",
            "city": "HOUGHTON",
            "state": "MI",
            "postal_code": "499312475",
            "telephone_number": "906-482-9404"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "901 W MEM DR",
            "city": "HOUGHTON",
            "state": "MI",
            "postal_code": "499312475",
            "telephone_number": "906-482-9404"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARQUARDT",
        "first_name": "GARY",
        "middle_name": "V",
        "credential": "LLMSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-09-04",
        "last_updated": "2013-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801094712",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Houghton, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2013; 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.