Individual provider Active NPI

Gayle M Tate-Casson, LICSW

  • Clinical Social Worker
  • Longview, WA
National Provider Identifier
1114911922
Registry record updated Oct 12, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LW00006409 Issued in WA
Practice address
600 Broadway St
Longview, WA 98632-3256
Phone
(360) 414-2222
Fax
(360) 414-2220
NPI assigned
Sep 7, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 12, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X LW00006409 WA
Clinical Social Worker 1041C0700X LW00006409 WA Primary

Addresses

Primary practice location

600 Broadway St
Longview, WA 98632-3256

Mailing address

PO Box 249
Longview, WA 98632-7154
Phone (360) 414-2048

Other identifiers 1

IdentifierTypeStateIssuer
8923628OtherWACRIME VICTIMS

Other names 1

  • Gayle M Tate Professional name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
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

Enrollment IDStateProvider typePAC IDDetails
I20101209001093 WA Practitioner - Clinical Social Worker 2264629773 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
PeacehealthGroup PAC ID 5890689293, 188 clinicians

Practice addresses (Care Compare)

1615 Delaware St
Longview, WA 98632-2367
Phone (360) 636-4814

600 Broadway St
Longview, WA 98632-3256
Phone (360) 414-2200

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Peacehealth CurrentSince Jan 1, 2002 Accepting new patients

Locations

1615 Delaware St
Longview, WA 98632
Phone (360) 363-4818

600 Broadway St
Longview, WA 98632
Phone (360) 414-2236

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": "1126051200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1318377600000",
    "number": "1114911922",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 249",
            "city": "LONGVIEW",
            "state": "WA",
            "postal_code": "986327154",
            "telephone_number": "360-414-2048",
            "fax_number": "360-414-2054"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 BROADWAY ST",
            "city": "LONGVIEW",
            "state": "WA",
            "postal_code": "986323256",
            "telephone_number": "360-414-2222",
            "fax_number": "360-414-2220"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TATE-CASSON",
        "first_name": "GAYLE",
        "middle_name": "M",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-09-07",
        "last_updated": "2011-10-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "WA",
            "license": "LW00006409",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WA",
            "license": "LW00006409",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CRIME VICTIMS",
            "identifier": "8923628",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "GAYLE",
            "last_name": "TATE",
            "middle_name": "M",
            "credential": "LICSW",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Longview, WA

Sources for this page

Verify at the official NPI Registry.