Gwendolyn C Dehorn, L.C.S.W

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

34003375 Issued in IN

Practice address

150 W Angela Blvd
South Bend, IN 46617-1101

Phone

(574) 245-3920

Fax

(573) 232-5386

NPI assigned

Jul 7, 2005

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Gwendolyn Dehorn LCSW LLC

  • Clinical Social Worker
  • South Bend, IN
  • NPI 1851159289
  NPD Authorized official
• David F Sonego MD PC & Associates

  • Mental Health Counselor
  • Mishawaka, IN
  • NPI 1063575108
  NPD (past)

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

{
    "created_epoch": "1120694400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1377561600000",
    "number": "1245237114",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "150 W ANGELA BLVD",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466171101",
            "telephone_number": "574-245-3920",
            "fax_number": "573-232-5386"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 W ANGELA BLVD",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466171101",
            "telephone_number": "574-245-3920",
            "fax_number": "573-232-5386"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEHORN",
        "first_name": "GWENDOLYN",
        "middle_name": "C",
        "name_prefix": "Mrs.",
        "credential": "L.C.S.W",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-07-07",
        "last_updated": "2013-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "IN",
            "license": "34003375",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IN",
            "license": "34003375",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENCE NUMBER",
            "identifier": "34003375",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "00000018781300",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kenna Defina, LMHC LCPC NCC
• Rachele A Defrancesco, MA
• Kara Degard
• Mary T Degeneffe, MD
• Amanda Leigh Dehn, FNP-BC
• Jane Ann Dejong, R.PH.
• Lisa R Dekker-Reed, DDS
• Christal Lynn Delaruelle, RN
• Miranda Delaruelle
• Brooke Delay

• Clinical Social Worker in South Bend, IN
• Providers in South Bend, IN by specialty
• Clinical Social Worker in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2013; 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.