Individual provider Active NPI

Gina C Villiere, LCSW-R

  • Clinical Social Worker
  • Saratoga Springs, NY
National Provider Identifier
1124141288
Registry record updated May 10, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
070868-1 Issued in NY
Practice address
530 Maple Ave
Saratoga Springs, NY 12866-5604
Phone
(518) 588-8378
NPI assigned
Apr 6, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 10, 2022

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 070868-1 NY Primary

Addresses

Primary practice location

530 Maple Ave
Saratoga Springs, NY 12866-5604

Mailing address

196 Grand Ave
Saratoga Springs, NY 12866-3928
Phone (518) 588-8378

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

LicenseStateTypeSpecialty
070868-1NYMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1175817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1652140800000",
    "number": "1124141288",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "196 GRAND AVE",
            "city": "SARATOGA SPRINGS",
            "state": "NY",
            "postal_code": "128663928",
            "telephone_number": "518-588-8378",
            "fax_number": "518-587-3087"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "530 MAPLE AVE",
            "city": "SARATOGA SPRINGS",
            "state": "NY",
            "postal_code": "128665604",
            "telephone_number": "518-588-8378"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VILLIERE",
        "first_name": "GINA",
        "middle_name": "C",
        "credential": "LCSW-R",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-06",
        "last_updated": "2022-05-10",
        "certification_date": "2022-05-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "070868-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saratoga Springs, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 10, 2022; 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.