Individual provider Active NPI

Gordon Dean Bathel, LCSW

  • Clinical Social Worker
  • Tucson, AZ
National Provider Identifier
1215959192
Registry record updated Apr 18, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LCSW-0974 Issued in AZ
Practice address
5210 E Pima St
Suite #140
Tucson, AZ 85712-3664
Phone
(520) 275-6780
Fax
(520) 795-3575
NPI assigned
Jul 23, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 18, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X LISAC-0167 AZ
Clinical Social Worker 1041C0700X LCSW-0974 AZ Primary

Addresses

Primary practice location

5210 E Pima St
Suite #140
Tucson, AZ 85712-3664

Mailing address

5210 E Pima St Ste 115
Tucson, AZ 85712-3691
Phone (520) 275-6780

Other identifiers 1

IdentifierTypeStateIssuer
CSW9741MedicaidAZ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
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
I20050301000248 AZ Practitioner - Clinical Social Worker 0749233872 Practice locations: Scottsdale, AZ

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1979
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

Scottsdale, AZ 85257
Phone (520) 275-6780

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LISAC-0167AZMDAddiction (Substance Use Disorder) Counselor
LCSW-0974AZMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Aleph Center, P.L.L.C. PastSince Mar 1, 1999 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.

NPI Registry JSON

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

{
    "created_epoch": "1153612800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1587168000000",
    "number": "1215959192",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5210 E PIMA ST STE 115",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857123691",
            "telephone_number": "520-275-6780",
            "fax_number": "520-795-3575"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5210 E PIMA ST",
            "address_2": "SUITE #140",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857123664",
            "telephone_number": "520-275-6780",
            "fax_number": "520-795-3575"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BATHEL",
        "first_name": "GORDON",
        "middle_name": "DEAN",
        "name_prefix": "Mr.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-23",
        "last_updated": "2020-04-18",
        "certification_date": "2020-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "AZ",
            "license": "LISAC-0167",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "AZ",
            "license": "LCSW-0974",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "CSW9741",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tucson, AZ

Sources for this page

Verify at the official NPI Registry.