Individual provider Active NPI

Gil Darrin Carde, LMSW

  • Clinical Social Worker
  • Fort Stewart, GA
National Provider Identifier
1073721338
Registry record updated Jul 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6801021536 Issued in MI
Practice address
1061 Harmon Ave
Ste 1D03
Fort Stewart, GA 31314-5611
Phone
(912) 435-6633
Fax
(616) 776-2934
NPI assigned
May 18, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 12, 2024

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 6801021536 MI Primary

Addresses

Primary practice location

1061 Harmon Ave
Ste 1D03
Fort Stewart, GA 31314-5611

Mailing address

233 Fulton St E Ste 114
Grand Rapids, MI 49503-3261
Phone (251) 533-5526

Other identifiers 4

IdentifierTypeStateIssuer
PVM190358MedicaidMI
80-0-89-5748-0OtherMIBLUE CROSS-BLUE SHIELD
7000020881OtherMAPRIORITY HEALTH
352744000OtherMIMAGELLAN

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
6801021536MIMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Perennial Health Services PLC Clinical CurrentSince Jul 21, 2024 Accepting new patients

Locations

233 Fulton St E
Ste 114
Grand Rapids, MI 49503
Phone (616) 633-7203

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1179446400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720742400000",
    "number": "1073721338",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "233 FULTON ST E STE 114",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495033261",
            "telephone_number": "251-533-5526",
            "fax_number": "706-301-3143"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1061 HARMON AVE",
            "address_2": "STE 1D03",
            "city": "FORT STEWART",
            "state": "GA",
            "postal_code": "313145611",
            "telephone_number": "912-435-6633",
            "fax_number": "616-776-2934"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARDE",
        "first_name": "GIL",
        "middle_name": "DARRIN",
        "name_prefix": "Prof.",
        "credential": "LMSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-18",
        "last_updated": "2024-07-12",
        "certification_date": "2024-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801021536",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PVM190358",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS-BLUE SHIELD",
            "identifier": "80-0-89-5748-0",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PRIORITY HEALTH",
            "identifier": "7000020881",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAGELLAN",
            "identifier": "352744000",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Stewart, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2024; 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.