Alexandra Elizabeth Gabridge

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

6801095726 Issued in MI

Practice address

1685 Baldwin Ave Ste 100
Pontiac, MI 48340-1115

Phone

(248) 706-3450

NPI assigned

May 1, 2018

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

Other names 1

• Alexandra Elizabeth Weaver Former name

Medicare fee-for-service enrollment

Enrolled in MI

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 1

Specialty

Clinical Social Worker

Education

Other, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

St Clair County Community Mental Health AuthorityGroup PAC ID 7416861984, 54 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• St Clair County Community Mental Health Authority

  • Community/Behavioral Health Agency
  • Port Huron, MI
  • NPI 1689783672
  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1525132800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727654400000",
    "number": "1073002424",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "37301 STONEGATE CIR",
            "city": "CLINTON TOWNSHIP",
            "state": "MI",
            "postal_code": "480362962",
            "telephone_number": "586-817-9094"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1685 BALDWIN AVE STE 100",
            "city": "PONTIAC",
            "state": "MI",
            "postal_code": "483401115",
            "telephone_number": "248-706-3450"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GABRIDGE",
        "first_name": "ALEXANDRA",
        "middle_name": "ELIZABETH",
        "name_prefix": "Ms.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-05-01",
        "last_updated": "2024-09-30",
        "certification_date": "2024-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MI",
            "license": "6801095726",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801095726",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ALEXANDRA",
            "last_name": "WEAVER",
            "middle_name": "ELIZABETH",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Chelsey Frommer, RCP
• Dana Marie Fuller, MA, LPC
• Laura A Fuller, MS, LPC, ATR
• Ellene Funke, LPC, CAADC, ATR, SCL
• James W Furlong, MD
• Jonathan Gaduski, DO
• Mary Lou Gagnon, CRNA
• Ravali Gali
• Galilee House L.L.C.
• Maria Gisela Gallardo, M.D.

• Clinical Social Worker in Pontiac, MI
• Providers in Pontiac, MI by specialty
• Clinical Social Worker in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2024; 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.