Individual provider Active NPI

Michel Jane Gotwals, LISW

  • Clinical Social Worker
  • Lancaster, OH
National Provider Identifier
1104137975
Registry record updated Apr 18, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
I.0900210 Issued in OH
Practice address
1334 Sheridan Dr
Lancaster, OH 43130-3956
Phone
(740) 653-9186
Fax
(740) 653-9214
NPI assigned
Jun 28, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 18, 2016

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 I.0900210 OH Primary

Addresses

Primary practice location

1334 Sheridan Dr
Lancaster, OH 43130-3956

Mailing address

1971 W 5TH Ave
Ste 2
Columbus, OH 43212-1905
Phone (614) 488-6285

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
I.0900210OHMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Ageless Counseling & Wellness Clinical CurrentSince Jul 22, 2025 Accepting new patients
Ageless Counseling Clinical CurrentSince Jun 2, 2024 Accepting new patients
John M. Showalter Dba Consulting Psychological Services Past Accepting new patients

Organizations & group practices 3

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": "1277683200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1460937600000",
    "number": "1104137975",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1971 W 5TH AVE",
            "address_2": "STE 2",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432121905",
            "telephone_number": "614-488-6285",
            "fax_number": "614-488-9592"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1334 SHERIDAN DR",
            "city": "LANCASTER",
            "state": "OH",
            "postal_code": "431303956",
            "telephone_number": "740-653-9186",
            "fax_number": "740-653-9214"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOTWALS",
        "first_name": "MICHEL",
        "middle_name": "JANE",
        "name_prefix": "Mrs.",
        "credential": "LISW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-06-28",
        "last_updated": "2016-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "I.0900210",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lancaster, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2016; 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.