Individual provider Active NPI

Chance Lee Gawlinski

  • Clinical Social Worker
  • Petoskey, MI
National Provider Identifier
1194373324
Registry record updated Aug 30, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6801105470 Issued in MI
Practice address
231 State St Ste 6
Petoskey, MI 49770-2785
Phone
(231) 881-8829
NPI assigned
Aug 30, 2019
Last updated
Aug 30, 2019By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 30, 2019

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 6801105470 MI Primary

Addresses

Primary practice location

231 State St Ste 6
Petoskey, MI 49770-2785

Mailing address

231 State St Ste 6
Petoskey, MI 49770-2785
Phone (231) 881-8829

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
6801105470MIMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Gawlinski Guidance and Counseling, LLC Clinical CurrentSince Mar 3, 2024 Accepting new patients
Second Chance Counseling Center Clinical PastSince Sep 1, 2019 Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1567123200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1567123200000",
    "number": "1194373324",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "231 STATE ST STE 6",
            "city": "PETOSKEY",
            "state": "MI",
            "postal_code": "497702785",
            "telephone_number": "231-881-8829"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "231 STATE ST STE 6",
            "city": "PETOSKEY",
            "state": "MI",
            "postal_code": "497702785",
            "telephone_number": "231-881-8829"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAWLINSKI",
        "first_name": "CHANCE",
        "middle_name": "LEE",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-08-30",
        "last_updated": "2019-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801105470",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Petoskey, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2019; 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.