Gavin William McCluskey I, LCSW, BCD

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

LCSW 14871 Issued in CA

Practice address

1820 J St
Sacramento, CA 95811-3010

Phone

(916) 737-5555

NPI assigned

Sep 4, 2014

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

Medicare fee-for-service enrollment

Enrolled in CA

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, 1984

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Permanente Medical Group IncGroup PAC ID 8921910225, 10,928 clinicians

Wellspace HealthGroup PAC ID 8426157975, 29 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.

• Wellspace Health

  • Federally Qualified Health Center (FQHC)
  • Sacramento, CA
  • NPI 1124112933
  Medicare reassignment Care Compare group NPD
• Permanente Medical Group Inc

  • Internal Medicine Physician
  • Santa Clara, CA
  • NPI 1073606299
  Medicare reassignment Care Compare group
• Wellspace Health

  • Federally Qualified Health Center (FQHC)
  • Sacramento, CA
  • NPI 1114682689
  NPD
• Wellspace Health

  • Federally Qualified Health Center (FQHC)
  • Roseville, CA
  • NPI 1811262348
  NPD
• Wellspace Health

  • Federally Qualified Health Center (FQHC)
  • Sacramento, CA
  • NPI 1548789050
  NPD (past)

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

{
    "created_epoch": "1409788800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1671580800000",
    "number": "1083015457",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3193 SPARROW DR",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958342639",
            "telephone_number": "916-515-0251",
            "fax_number": "916-515-0251"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1820 J ST",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958113010",
            "telephone_number": "916-737-5555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCLUSKEY",
        "first_name": "GAVIN",
        "middle_name": "WILLIAM",
        "name_prefix": "Mr.",
        "name_suffix": "I",
        "credential": "LCSW, BCD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-09-04",
        "last_updated": "2022-12-21",
        "certification_date": "2022-12-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "LCSW 14871",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jordan McCloughan
• Crystal McClure
• Elizabeth M McClure, MD
• Erin Ann McClure
• Payton McClure
• Michelle Nicole McCluskey, MFT
• Ruth Elaine McColgan
• Graham McColl
• Jacqueline McCollum
• Jamie McCollum

• Clinical Social Worker in Sacramento, CA
• Providers in Sacramento, CA by specialty
• Clinical Social Worker in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 2022; 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.