Gina Reed Licensed Clinical Social Worker Psychotherapy Services Corp

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

Legal business name

GINA REED LICENSED CLINICAL SOCIAL WORKER PSYCHOTHERAPY SERVICES CORP

Practice address

6024 Sundale CT
El Dorado HLS, CA 95762-7648

Phone

(916) 224-6937

NPI assigned

Nov 20, 2020

Organization subpart

No

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

Authorized official

Name

Gina Reed, LCSWNPI 1891156501

Title

President

Phone

(916) 224-6937

Specialties & licenses 1

Addresses

Other names 1

• Elevations Counseling Center Doing business as

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Gina Reed, LCSW

  • Clinical Social Worker
  • El Dorado Hills, CA
  • NPI 1891156501
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1605830400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1605830400000",
    "number": "1205439155",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6024 SUNDALE CT",
            "city": "EL DORADO HLS",
            "state": "CA",
            "postal_code": "957627648",
            "telephone_number": "916-224-6937"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6024 SUNDALE CT",
            "city": "EL DORADO HLS",
            "state": "CA",
            "postal_code": "957627648",
            "telephone_number": "916-224-6937"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GINA REED LICENSED CLINICAL SOCIAL WORKER PSYCHOTHERAPY SERVICES CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-11-20",
        "last_updated": "2020-11-20",
        "certification_date": "2020-11-20",
        "status": "A",
        "authorized_official_last_name": "REED",
        "authorized_official_first_name": "GINA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "916-224-6937",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Elevations Counseling Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.