Todd Allen Gjerdevig, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

37507 Issued in TX

Practice address

180 State St Ste 225
Southlake, TX 76092-7632

Phone

(817) 908-0296

NPI assigned

Oct 9, 2008

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in TX

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, 2002

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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

• Todd Gjerdevig

  • Clinical Social Worker
  • Grapevine, TX
  • NPI 1376938613
  NPD (past) Authorized official
• Assurasource LTD

  • Clinical Social Worker
  • Plano, TX
  • NPI 1194746016
  NPD (past)

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

{
    "created_epoch": "1223510400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1579046400000",
    "number": "1073764957",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "180 STATE ST STE 225",
            "city": "SOUTHLAKE",
            "state": "TX",
            "postal_code": "760927632",
            "telephone_number": "817-908-0296"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "180 STATE ST STE 225",
            "city": "SOUTHLAKE",
            "state": "TX",
            "postal_code": "760927632",
            "telephone_number": "817-908-0296"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GJERDEVIG",
        "first_name": "TODD",
        "middle_name": "ALLEN",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-10-09",
        "last_updated": "2020-01-15",
        "certification_date": "2020-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TX",
            "license": "37507",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "207198701",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Casey Giles
• Christopher Gilman, PHARM D
• Gina Aalund, LCSW, PLLC
• Sneha Goswami Giri, MD
• Greg L Gist, DDS
• Global Anesthesia Specialists, PLLC
• Global Brain Center Uddin PLLC
• Global Brain Center,LLC
• Global Brain Eeg
• Global Brain Eeg, LLC

• Clinical Social Worker in Southlake, TX
• Providers in Southlake, TX by specialty
• Clinical Social Worker in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2020; 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.