Active NPI
Nicole Gaither, MSW. LSW
- Social Worker
- Marion, IL
National Provider Identifier
1104694637
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 150.114614
- Practice address
- 1307 W Main St
Marion, IL 62959-1139 - Phone
- (618) 997-5336
- Fax
- (618) 993-2969
- NPI assigned
- Dec 14, 2023
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | 150.114614 | IL | Primary |
Addresses
Primary practice location
1307 W Main St
Marion, IL 62959-1139
Mailing address
902 W Main St
West Frankfort, IL 62896-2210
Phone (618) 937-6483
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 150.114614 | IL | MD | Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Wellspire Counseling PLLC | Past | Accepting new patients |
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.
-
- Clinical Psychologist
- Chicago, IL
- NPI 1609594415
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1702512000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1728604800000",
"number": "1104694637",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "902 W MAIN ST",
"city": "WEST FRANKFORT",
"state": "IL",
"postal_code": "628962210",
"telephone_number": "618-937-6483",
"fax_number": "618-937-1440"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1307 W MAIN ST",
"city": "MARION",
"state": "IL",
"postal_code": "629591139",
"telephone_number": "618-997-5336",
"fax_number": "618-993-2969"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GAITHER",
"first_name": "NICOLE",
"credential": "MSW. LSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-12-14",
"last_updated": "2024-10-11",
"certification_date": "2024-10-11",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "IL",
"license": "150.114614",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Marion, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 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.